MEDICARE: DR. SARAH KRISTIN ANDERSEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	029233	ZZ

General Provider Information

NPI Number	:	1578172425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH KRISTIN ANDERSEN MD

Provider Business Mailing Address
First Line	:	4048 WEST 32ND AVENUE
Second Line	:
City	:	VANCOUVER
State	:	BC
Zip	:	V6S1Z6
Country	:	CA
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4048 WEST 32ND AVENUE
Second Line	:
City	:	VANCOUVER
State	:	BC
Zip	:	V6S1Z6
Country	:	CA
Telephone Number	:	416-274-9686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	08/08/2020

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