Provider Demographics
NPI:1891344560
Name:GOTTLIEB, ANNA JOY
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:JOY
Last Name:GOTTLIEB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:JOY
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18517 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SUQUAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98392-9784
Mailing Address - Country:US
Mailing Address - Phone:206-499-6361
Mailing Address - Fax:
Practice Address - Street 1:18517 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:SUQUAMISH
Practice Address - State:WA
Practice Address - Zip Code:98392-9784
Practice Address - Country:US
Practice Address - Phone:206-499-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical