Provider Demographics
NPI:1972908440
Name:RHODES, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12213 NE 67TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8546
Mailing Address - Country:US
Mailing Address - Phone:512-897-4430
Mailing Address - Fax:
Practice Address - Street 1:12213 NE 67TH STREET
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8546
Practice Address - Country:US
Practice Address - Phone:512-897-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-LIC-8790235Z00000X
TX107983235Z00000X
WA60466928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist