Provider Demographics
NPI:1265076293
Name:HOWARD, ANNIKA SHUNTA
Entity type:Individual
Prefix:MS
First Name:ANNIKA
Middle Name:SHUNTA
Last Name:HOWARD
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 1:522 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6322
Mailing Address - Country:US
Mailing Address - Phone:206-859-7765
Mailing Address - Fax:206-374-8107
Practice Address - Street 1:1701 18TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4317
Practice Address - Country:US
Practice Address - Phone:206-731-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit