Provider Demographics
NPI:1194136937
Name:ARMIN, ANAHITA
Entity type:Individual
Prefix:
First Name:ANAHITA
Middle Name:
Last Name:ARMIN
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 1:104 W MAIN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-8904
Mailing Address - Country:US
Mailing Address - Phone:253-686-1319
Mailing Address - Fax:
Practice Address - Street 1:104 W MAIN
Practice Address - Street 2:SUITE 202
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-8904
Practice Address - Country:US
Practice Address - Phone:253-686-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60314423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60321544711OtherUBI NO.
WAMC60314423OtherLMHC