Individual
DR. LARRY SIMON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Mailing address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00010119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115842
LNI PROVIDER ID
WA
05
—
8197105
—
WA
Enumeration date
09/30/2005
Last updated
02/04/2015
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