Provider Demographics
NPI:1942770508
Name:RECUN, ANNA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:RECUN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 136TH PL SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-3437
Mailing Address - Country:US
Mailing Address - Phone:206-372-1915
Mailing Address - Fax:
Practice Address - Street 1:22635 NE MARKETPLACE DR # 130
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5885
Practice Address - Country:US
Practice Address - Phone:425-949-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60886575171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist