Provider Demographics
NPI:1578306262
Name:LE, ANNA THANH
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:THANH
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W MALLON AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1840
Mailing Address - Country:US
Mailing Address - Phone:503-621-6223
Mailing Address - Fax:
Practice Address - Street 1:1601 SW JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331-8656
Practice Address - Country:US
Practice Address - Phone:541-737-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program