Individual
MICHAEL R ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4011 TALBOT RD S, #220, RENTON, WA 98055-5791
(425) 656-5300
(425) 656-5402
Mailing address
4011 TALBOT RD S, #220, RENTON, WA 98055-5791
(425) 656-5300
(425) 656-5402
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00014404
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1094895
—
WA
01
—
AN6847
REGENCE
WA
Enumeration date
09/15/2005
Last updated
07/09/2007
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