Individual
DR. ANNA RAE BANEZ ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 493-4069
Mailing address
PO BOX 3360, YALE NEW HAVEN HOSPITAL, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60328767
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD60328767
STATE LICENSE
WA
Enumeration date
03/03/2008
Last updated
03/19/2013
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