Provider Demographics
NPI:1851519367
Name:BAILEY, ANNA K (LMP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:BAILEY
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 1:1530 S UNION AVE
Mailing Address - Street 2:STE 14
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1954
Mailing Address - Country:US
Mailing Address - Phone:253-752-3360
Mailing Address - Fax:253-752-3365
Practice Address - Street 1:1530 S UNION AVE
Practice Address - Street 2:STE 14
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1954
Practice Address - Country:US
Practice Address - Phone:253-752-3360
Practice Address - Fax:253-752-3365
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017120225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist