Provider Demographics
NPI:1841330750
Name:OSNIS, ANNIE (NP)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:OSNIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:8980 161ST AVE NE
Practice Address - Street 2:SUITE 410
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7554
Practice Address - Country:US
Practice Address - Phone:425-883-3333
Practice Address - Fax:425-869-4854
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12997207P00000X
WAAP60064805363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN573926Medicaid
CARN573926Medicaid
WAG8904647Medicare PIN
P47645Medicare UPIN
ZZZ21996ZMedicare ID - Type Unspecified