Individual
RAE ANN IAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
11216 SUNRISE BLVD E, STE 3-207, PUYALLUP, WA 98374-8848
(253) 770-3700
(253) 435-7019
Mailing address
3209 S 23RD ST, STE 340, TACOMA, WA 98405-1602
(253) 383-8342
(253) 572-8204
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60403597
WA
363LF0000X
Family Nurse Practitioner
AP 60403597
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033476
—
WA
01
—
AP60403597
WA LICENSE ARNP
WA
01
—
G000188100
GROUP PTAN(K)
WA
01
—
G001045700
GROUP PTAN(P)
WA
Enumeration date
08/07/2013
Last updated
08/26/2020
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