Provider Demographics
NPI:1144318809
Name:THURESON, ANNE MARGARET (LICSW)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARGARET
Last Name:THURESON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17534 SE 135TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-7107
Mailing Address - Country:US
Mailing Address - Phone:206-406-9701
Mailing Address - Fax:206-241-7321
Practice Address - Street 1:16300 CHRISTENSEN RD STE 108
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3418
Practice Address - Country:US
Practice Address - Phone:206-241-5697
Practice Address - Fax:206-241-7321
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000050051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000108353 80Medicare ID - Type Unspecified