MEDICARE: DR. GILL EARL ANDERSON 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	207V00000X	Obstetrics & Gynecology Physician	MD00015271	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578659413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILL EARL ANDERSON MD

Provider Business Mailing Address
First Line	:	13030 121ST WAY NE
Second Line	:	#202
City	:	KIRKLAND
State	:	WA
Zip	:	90034-3008
Country	:	US
Telephone Number	:	425-821-2020
Fax Number	:	425-823-8273

Provider Business Practice Location Address
First Line	:	13030 121ST WAY NE
Second Line	:	#202
City	:	KIRKLAND
State	:	WA
Zip	:	90034-3008
Country	:	US
Telephone Number	:	425-821-2020
Fax Number	:	425-823-8273

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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