Provider Demographics
NPI:1588318927
Name:MOSHE-SMITH, ANNA RIZIKI
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:RIZIKI
Last Name:MOSHE-SMITH
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 1:11615 HIGHWAY 99 APT C102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7825
Mailing Address - Country:US
Mailing Address - Phone:253-326-2771
Mailing Address - Fax:
Practice Address - Street 1:11615 HIGHWAY 99 APT C102
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-7825
Practice Address - Country:US
Practice Address - Phone:253-326-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60958037164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse