Individual
ANNELIESE N. TRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
945 GOETHALS DR STE 300, RICHLAND, WA 99352-3552
(509) 943-3196
(509) 946-0455
Mailing address
550 GAGE BLVD STE 101, RICHLAND, WA 99352-9532
(509) 473-0637
(509) 627-2983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61157642
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA61157642
DOH LICENSE
WA
Enumeration date
07/12/2021
Last updated
05/08/2024
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