Anastasia Khan, RN

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

RN60023168 Issued in WA

Practice address

9400 Gravelly Lake Dr SW
Lakewood, WA 98499-1512

Phone

(253) 584-1459

NPI assigned

Jan 10, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tony Dee Cacabelos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington CVS Pharmacy LLC

  • Pharmacy
  • Lakewood, WA
  • NPI 1063992766
  NPD (past)
• Washington CVS Pharmacy LLC

  • Pharmacy
  • Mercer Island, WA
  • NPI 1194834408
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1871181370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 RIGNEY RD APT F11",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983882833",
            "telephone_number": "253-905-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991512",
            "telephone_number": "253-584-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ANASTASIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60023168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "CACABELOS",
            "middle_name": "DEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Kester
• Toni L Kester, LMP
• Kevin E. Braun, MD PLLC
• Key Bridge Medical Clinic LLC
• Keyna Graham-Heine, PLLC
• Asif Khan, MD
• Sheik N Khan, M.D.
• Ranju Kharel
• Vanyda Khoeuy, COTA/L
• Robert L Kiehl, DDS

• Emergency Registered Nurse in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Emergency Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.