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Individual

DANIEL STEPHEN ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
12651 SE LINCOLN ST, PORTLAND, OR 97233-1370
(425) 891-3538
Mailing address
12651 SE LINCOLN ST, PORTLAND, OR 97233-1370
(425) 891-3538

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
65098
OR
225100000X
Physical Therapist
PT60257881
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205105202
WA
01
G8968737
MEDICARE
WA
01
P01153274
RR MEDICARE
OR
Enumeration date
12/20/2011
Last updated
10/10/2023
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