Provider Demographics
NPI:1952327850
Name:TUTTLE, ANNE E (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11695 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5268
Mailing Address - Country:US
Mailing Address - Phone:425-637-1855
Mailing Address - Fax:206-344-7970
Practice Address - Street 1:11695 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5268
Practice Address - Country:US
Practice Address - Phone:425-637-1855
Practice Address - Fax:206-344-7970
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5167TUOtherBLUE SHIELD
WAUS2551195OtherAETNA/USHC SPECIALIST
WA8286650Medicaid
WAMD7566WOtherALASKA MEDICAID
WAUS0083039OtherAETNA/USHC PCP
WA0039581OtherLABOR & INDUSTRY
H43690Medicare UPIN
WAMD7566WOtherALASKA MEDICAID
WAAB33504Medicare PIN
WA8852236Medicare PIN