Provider Demographics
NPI:1861632945
Name:HALLMARK, ANNA TERI (LMP)
Entity Type:Individual
Prefix:
First Name:ANNA TERI
Middle Name:
Last Name:HALLMARK
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:TYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3212 164TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6072
Mailing Address - Country:US
Mailing Address - Phone:360-789-6245
Mailing Address - Fax:
Practice Address - Street 1:3212 164TH PL SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6072
Practice Address - Country:US
Practice Address - Phone:360-789-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist