Provider Demographics
NPI:1558480939
Name:KRAEMER, ANJA (PHT)
Entity type:Individual
Prefix:
First Name:ANJA
Middle Name:
Last Name:KRAEMER
Suffix:
Gender:F
Credentials:PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26926 SE 407TH ST
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-8513
Mailing Address - Country:US
Mailing Address - Phone:360-825-5878
Mailing Address - Fax:253-840-5013
Practice Address - Street 1:929 E MAIN STE 310
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3116
Practice Address - Country:US
Practice Address - Phone:253-840-2441
Practice Address - Fax:253-840-5013
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00012538183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician