Provider Demographics
NPI:1992963433
Name:ANKER, DARLENE MAE (OD)
Entity type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:MAE
Last Name:ANKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DARLENE
Other - Middle Name:MAE
Other - Last Name:YOUNG-ANKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:410 W BAKERVIEW RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8184
Mailing Address - Country:US
Mailing Address - Phone:360-392-8306
Mailing Address - Fax:360-778-1378
Practice Address - Street 1:410 W BAKERVIEW RD
Practice Address - Street 2:SUITE 107
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8184
Practice Address - Country:US
Practice Address - Phone:360-392-8306
Practice Address - Fax:360-778-1378
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1747152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2034577Medicaid
WA2034577Medicaid