Grimm, Anna Kathleen
Grimm, Anna Kathleen is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Grimm, Anna Kathleen can be contacted via phone (503) 494-1303.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-1303
Fax: (503) 346-8021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 33115 | West Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | COA.03700-NP | Ohio |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | COA.03700-NP | Ohio |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 201501103NP-PP | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 201501120NP-PP | Oregon |
Profile Details
| NPI number | 1033151139 |
|---|---|
| LBN Legal business name | Grimm, Anna Kathleen |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Jun 21st, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033151139 | NPPES |
| West Virginia | MEDICAID | 3810001991 | |
| West Virginia | MEDICAID | 0051782 | |
| West Virginia | Other | 1067391 |
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