Basic Information
Provider Information
NPI: 1568548311
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COLLIER
FirstName: ANN
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065436420
FaxNumber:  
Practice Location
Address1: HARBORVIEW MEDICAL CENTER
Address2: 325 9TH AVE
City: SEATTLE
State: WA
PostalCode: 98104
CountryCode: US
TelephoneNumber: 2067313000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2006
LastUpdateDate: 01/23/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200XMD00017676WAY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

ID Information
IDTypeStateIssuerDescription
217501 INTERNAL ID-MOTOR VEHICLE IDOTHER
P0011499201WARAIL ROAD MEDICAREOTHER
156854831105WA MEDICAID


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