Provider Demographics
NPI:1871646877
Name:GRIMSLEY, ANKE ULRIKE (LMP)
Entity type:Individual
Prefix:MRS
First Name:ANKE
Middle Name:ULRIKE
Last Name:GRIMSLEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 29TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-3558
Mailing Address - Country:US
Mailing Address - Phone:360-412-8214
Mailing Address - Fax:360-923-2268
Practice Address - Street 1:4412 PACIFIC AVE SE
Practice Address - Street 2:SUITE 203
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1119
Practice Address - Country:US
Practice Address - Phone:360-280-3326
Practice Address - Fax:360-923-2268
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013618174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist