Provider Demographics
NPI:1316714934
Name:WOERNER, ANTHONY PAUL
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:PAUL
Last Name:WOERNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 WANAMAKER RD
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-3803
Mailing Address - Country:US
Mailing Address - Phone:435-640-0144
Mailing Address - Fax:
Practice Address - Street 1:588 WANAMAKER RD
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3803
Practice Address - Country:US
Practice Address - Phone:435-640-0144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160698029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist