Individual
CLINTON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 BOTHELL EVERETT HWY, EVERETT, WA 98208-6642
(425) 316-5150
(425) 225-1006
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 366-2983
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
41558
MN
207Q00000X
Family Medicine Physician
Primary
MD60037715
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062M8AN
BLUE CROSS
MN
05
—
127521
—
MN
05
—
3526343
—
IA
05
—
390405933
—
MN
05
—
8523219
—
WA
Enumeration date
12/23/2005
Last updated
02/05/2015
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