Provider Demographics
NPI:1962100016
Name:WRIGHT, ANNA LAUREN
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LAUREN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LAUREN
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST BOX 357134
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7134
Mailing Address - Country:US
Mailing Address - Phone:206-543-5982
Mailing Address - Fax:
Practice Address - Street 1:8221 5TH AVE NE APT 303
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4194
Practice Address - Country:US
Practice Address - Phone:760-803-3808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61564790122300000X
WADR61441289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist