Provider Demographics
NPI:1750532057
Name:SLATER, ANNA MARIA (LMP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:SLATER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST
Mailing Address - Street 2:SUITE # 118
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3539
Mailing Address - Country:US
Mailing Address - Phone:425-577-8666
Mailing Address - Fax:425-869-1724
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE # 118
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-577-8666
Practice Address - Fax:425-869-1724
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-05
Last Update Date:2008-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016257225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist