Individual
MARK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 SE 172ND AVE, VANCOUVER, WA 98684-9542
(360) 882-2778
(360) 604-1723
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00029121
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211889
WA L & I
WA
05
—
8459919
—
WA
01
—
P00354423
RR MEDICARE
WA
Enumeration date
04/10/2006
Last updated
08/28/2015
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