Anderson, Mark

Anderson, Mark is an individual health care provider with primary practice located at 501 Se 172Nd Ave , Vancouver WA 98684-9542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Anderson, Mark can be contacted via phone (360) 882-2778.

Contact Information

Primary practice address
501 Se 172Nd Ave Vancouver WA 98684-9542
Phone: (360) 882-2778
Fax: (360) 604-1723
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD00029121 Washington

Profile Details

NPI number 1376506501
LBN Legal business name Anderson, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Aug 28th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376506501 NPPES
Washington Other 211889 WA L & I
Washington Other P00354423 WA L & I
Washington MEDICAID 8459919 WA L & I

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