| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ANNIE GADDIS | 1053048272 | 2022-08-07 |
Annie Gaddis is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1053048272. Registration indicates Annie Gaddis is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Annie Gaddis |
| Practice Office Address | 1128 BROADWAY ST LONGVIEW, WA US |
| Practice Office Telephone | 3602616930 |
| Mailing Address | 1820 SUSAN AVE LONGVIEW, WA 986323326 US |
| Business Telephone | 3609530618 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |