Healthcare Provider Details

I. General information

NPI: 1174529341
Provider Name (Legal Business Name): ARTHUR ERIC ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/03/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 116TH AVE NE STE 209
BELLEVUE WA
98004-3825
US

IV. Provider business mailing address

1902 48TH AVE SW
SEATTLE WA
98116-1945
US

V. Phone/Fax

Practice location:
  • Phone: 425-453-8406
  • Fax:
Mailing address:
  • Phone: 425-453-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD00045087
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: