Provider Demographics
NPI:1992843296
Name:GIUSTOZZI, ANNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:GIUSTOZZI
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 1:13210 SE 240TH ST
Mailing Address - Street 2:A6
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5182
Mailing Address - Country:US
Mailing Address - Phone:253-854-9570
Mailing Address - Fax:253-854-3478
Practice Address - Street 1:13210 SE 240TH ST
Practice Address - Street 2:A6
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-5182
Practice Address - Country:US
Practice Address - Phone:253-854-9570
Practice Address - Fax:253-854-3478
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034580173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8211815Medicaid
WA8211815Medicaid