Individual
DR. BRENT D. ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 SW WASHINGTON ST, SUITE 700, PORTLAND, OR 97205-3536
(503) 299-9906
(503) 225-9002
Mailing address
PO BOX 35147 #1801, SEATTLE, WA 98124-5147
(503) 299-9906
(503) 225-9002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD17257
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050038326
RR MEDICARE
OR
05
—
071386
—
OR
05
—
8174187
—
WA
05
—
XPY197445
—
CA
Enumeration date
02/14/2006
Last updated
10/10/2018
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