| Doctor Name: | DR. SUSAN ANDERSON |
| NPI Number: | 1477518512 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PY00003076 |
| Business Practice Address: | 311 Ne 3rd St Coupeville, WA - 982393427 |
| Business Phone Number: | 3606782273 |
| Business Fax Number: | |
| Mailing Address: | 9340 Ne 76th St, VANCOUVER |
| State: | WA |
| Postal Code: | 986623721 |
| Phone Number: | 3602534912 |
| Fax Number: | 3602535170 |
| NPI Enumeration Date: | 04/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003076 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |