Individual
DIANNE L ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
55 1ST PL NW, SUITE 4, ISSAQUAH, WA 98027-3271
(425) 394-0301
(425) 394-0287
Mailing address
55 1ST PL NW, SUITE 4, ISSAQUAH, WA 98027-3271
(425) 394-0301
(425) 394-0287
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00002455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7675082
AETNA US HEALTHCARE PIN
—
01
—
AN8462
REGENCE PIN
WA
Enumeration date
01/09/2007
Last updated
07/08/2007
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