Provider Demographics
NPI:1740005230
Name:CHANDLER, ANN CHAMPION (RN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:CHAMPION
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S OLYMPIC AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1567
Mailing Address - Country:US
Mailing Address - Phone:530-410-8641
Mailing Address - Fax:
Practice Address - Street 1:9617 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3710
Practice Address - Country:US
Practice Address - Phone:425-513-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00127013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse