Provider Demographics
NPI:1811612518
Name:JUDGE, ANAKA DANIELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:ANAKA
Middle Name:DANIELLE
Last Name:JUDGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANAKA
Other - Middle Name:DANIELLE
Other - Last Name:HAKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5808 SE SCHILLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-4764
Mailing Address - Country:US
Mailing Address - Phone:360-927-1563
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202214815RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse