Provider Demographics
NPI:1376384925
Name:STOLARCZUK, ANNA ROSE (DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ROSE
Last Name:STOLARCZUK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ROSE
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:111 TUMWATER BLVD SE STE 113
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6422
Mailing Address - Country:US
Mailing Address - Phone:425-869-2777
Mailing Address - Fax:425-869-0167
Practice Address - Street 1:15446 BEL RED RD STE B20
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5526
Practice Address - Country:US
Practice Address - Phone:425-869-2777
Practice Address - Fax:425-869-0167
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61569085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist