Individual
ANNE EVE CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2811 TIETON DR, YAKIMA, WA 98902-3761
(509) 575-8100
Mailing address
PO BOX 45850, SEATTLE, WA 98145-0850
(206) 543-8626
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00043468
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MD00043468
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184073
LABOR&INDUSTRIES PROV#
WA
01
—
0442KA
REGENCE PROV #
WA
05
—
8391096
—
WA
Enumeration date
09/06/2006
Last updated
06/18/2020
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