Provider Demographics
NPI:1639491426
Name:STEADEMAN, ANNA MICHELLE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MICHELLE
Last Name:STEADEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N CLEVELAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2690
Mailing Address - Country:US
Mailing Address - Phone:360-860-1158
Mailing Address - Fax:
Practice Address - Street 1:117 N CLEVELAND AVE APT 3
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5384
Practice Address - Country:US
Practice Address - Phone:509-884-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60131183225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist