Provider Demographics
NPI:1649587957
Name:HOUSTON, ANNA ELIZABETH (LMP)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:ELIZABETH
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 GRAND AVE
Mailing Address - Street 2:STE 101 AND 102
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3482
Mailing Address - Country:US
Mailing Address - Phone:425-257-0177
Mailing Address - Fax:425-257-1088
Practice Address - Street 1:2824 GRAND AVE
Practice Address - Street 2:STE 101 AND 102
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3489
Practice Address - Country:US
Practice Address - Phone:425-257-0177
Practice Address - Fax:425-257-1088
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021955225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist