Individual
CHARLES CHRISTIAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W 8TH AVE, SUITE 4300, SPOKANE, WA 99204-2307
(509) 747-6707
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 747-6707
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD00041066
WA
2080P0202X
Pediatric Cardiology Physician
M-8783
ID
2080P0202X
Pediatric Cardiology Physician
Primary
MD00041066
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806322000
—
ID
Enumeration date
05/18/2006
Last updated
04/05/2021
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