Doctor Name: | DR. EARLINE ANDERSON |
NPI Number: | 1013089192 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PY00001412 |
Business Practice Address: | 55 1st Pl Nw Issaquah, WA - 980273271 |
Business Phone Number: | 4253920277 |
Business Fax Number: | 4253922509 |
Mailing Address: | 55 1st Pl Nw, ISSAQUAH |
State: | WA |
Postal Code: | 980273271 |
Phone Number: | 4253920277 |
Fax Number: | 4253922509 |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PY00001412 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |