Provider Demographics
NPI:1841481751
Name:HIEMSTRA, ANNEMIEKE JEANETTE (CRNA)
Entity type:Individual
Prefix:
First Name:ANNEMIEKE
Middle Name:JEANETTE
Last Name:HIEMSTRA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANNEMIEKE
Other - Middle Name:JEANETTE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9376 SE 46TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4405
Mailing Address - Country:US
Mailing Address - Phone:206-275-3794
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-731-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007718367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8867401.Medicare PIN