Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 95002440 | CA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP60779722 | WA |
NPI | 1023496668 |
---|---|
Provider Name | Anna Timbol |
First Address | Seattle, WA 98104-1132 |
Second Address | Seattle, WA 98104-1132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2015 |
Last Update Date | 17/03/2018 |