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Individual

GERALD W ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3315 SO 23, #200, TACOMA, WA 98405
(253) 627-0114
(253) 627-0498
Mailing address
3725 123RD STREET CT NW, GIG HARBOR, WA 98332-8904
(253) 627-0114
(253) 627-0498

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00015029
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102486
LTI
05
1057264
WA
01
AN5612
REGENCE
Enumeration date
10/20/2006
Last updated
08/08/2017
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