Healthcare Provider Details

I. General information

NPI: 1427023670
Provider Name (Legal Business Name): DENISE ANDERSEN HEALTH SERVICE TECH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USCGC HEALY WAGB 20 1519 ALASKAN WAY SOUTH
SEATTLE AL
98134-1192
US

IV. Provider business mailing address

USCGC HEALY WAGB 20 1519 ALASKAN WAY SOUTH
SEATTLE AL
98134-1192
US

V. Phone/Fax

Practice location:
  • Phone: 206-217-6300
  • Fax: 206-217-6309
Mailing address:
  • Phone: 206-217-6300
  • Fax: 206-217-6309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: