Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD00046103 | WA |
NPI | 1205887056 |
---|---|
Provider Name | Christopher George Anderson |
First Address | Spokane, WA 99216 |
Second Address | Spokane, WA 99216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0155873 | (05) | MT |
0206858 | DEPT OF LABOR & INDUSTRIE (01) | WA |
3131AN | ASURIS (01) | |
3131AN | ASURIS NW HEALTH (01) | |
807413200 | (05) | ID |
8449464 | (05) | WA |
G8860150 | MEDICARE WA (01) | WA |
I53009 | (02) | |
P00346484 | RR MEDICARE (01) |