Individual
DR. WENDY WAN ANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24920 104TH AVE SE, KENT, WA 98030-6443
(425) 690-3544
(425) 690-9444
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P1616
TX
207RN0300X
Nephrology Physician
Primary
MD60614954
WA
207RN0300X
Nephrology Physician
P1616
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062995
—
WA
01
—
60614954
WA MEDICAL LICENSE
WA
01
—
P1616
LICENSE
TX
Enumeration date
05/30/2007
Last updated
10/04/2022
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