Healthcare Provider Details

I. General information

NPI: 1801321971
Provider Name (Legal Business Name): JEFFREY ALAN ANDERSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19206 SE 1ST ST STE 118
CAMAS WA
98607-7478
US

IV. Provider business mailing address

19206 SE 1ST ST STE 118
CAMAS WA
98607-7478
US

V. Phone/Fax

Practice location:
  • Phone: 136-043-3901
  • Fax:
Mailing address:
  • Phone: 360-433-9016
  • Fax: 360-433-9809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5800
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60773276
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: