Provider Demographics
NPI:1215346770
Name:QUAST, ANNA B (DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:B
Last Name:QUAST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:BRAML
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0480
Mailing Address - Country:US
Mailing Address - Phone:253-840-2313
Mailing Address - Fax:253-840-6340
Practice Address - Street 1:25012 104TH AVE SE
Practice Address - Street 2:SUITE C
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2821
Practice Address - Country:US
Practice Address - Phone:253-856-3477
Practice Address - Fax:253-856-3478
Is Sole Proprietor?:No
Enumeration Date:2014-08-10
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60475446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist