Provider Demographics
NPI:1700997657
Name:GIUTTARI-ANDERSEN, DEBRA MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:GIUTTARI-ANDERSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E ROWAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1240
Mailing Address - Country:US
Mailing Address - Phone:509-489-2101
Mailing Address - Fax:509-252-1561
Practice Address - Street 1:235 E ROWAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1240
Practice Address - Country:US
Practice Address - Phone:509-489-2101
Practice Address - Fax:509-252-1561
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002049363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9648452Medicaid
WAPENDINGMedicare UPIN
WA9648452Medicaid
WA8863592Medicare PIN