Individual
DR. JOE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9695 NW KAISER RD, PORTLAND, OR 97231-2736
(503) 686-1172
Mailing address
9695 NW KAISER RD, PORTLAND, OR 97231-2736
(503) 686-1172
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD13822
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050049894
RR MEDICARE
OR
05
—
205518
—
OR
05
—
8109449
—
WA
Enumeration date
02/15/2006
Last updated
04/21/2017
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