Individual
MARVIN NEIL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1200 CHESTERLY DR STE 100, YAKIMA, WA 98902-7339
(509) 712-2902
(509) 554-5595
Mailing address
1200 CHESTERLY DR STE 100, YAKIMA, WA 98902-7339
(509) 712-2902
(509) 554-5595
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60539401
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3925891
—
TN
01
—
4110408
BLUECROSS BLUESHIELD #
TN
01
—
500566
VALUE OPTIONS PROVIDER #
TN
Enumeration date
12/14/2006
Last updated
10/25/2023
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