Individual
ANTHONY D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP,PTA
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5166
(971) 206-5211
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5166
(971) 206-5211
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019881
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0189046
LABOR AND INDUSTRIES
WA
Enumeration date
09/22/2006
Last updated
05/19/2010
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