Provider Demographics
NPI:1265909063
Name:WOLTERS, ANNALEE (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ANNALEE
Middle Name:
Last Name:WOLTERS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 236TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-9673
Mailing Address - Country:US
Mailing Address - Phone:253-880-4299
Mailing Address - Fax:
Practice Address - Street 1:501 ORAVETZ RD SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8621
Practice Address - Country:US
Practice Address - Phone:253-804-5161
Practice Address - Fax:253-804-5168
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60384299163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool