Provider Demographics
NPI:1770216657
Name:STRAND, ANNA TAMAR
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:TAMAR
Last Name:STRAND
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 1:374 COULSON RD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8408
Mailing Address - Country:US
Mailing Address - Phone:360-270-2550
Mailing Address - Fax:
Practice Address - Street 1:3285 FERGUSON ST SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6143
Practice Address - Country:US
Practice Address - Phone:360-943-1907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60392342164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse