Healthcare Provider Details

I. General information

NPI: 1346334489
Provider Name (Legal Business Name): HAROLD FRANK ANDERSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PACIFIC AVE 4TH FLOOR
EVERETT WA
98201-4168
US

IV. Provider business mailing address

1321 COLBY AVE MEDICAL STAFF OFFICE
EVERETT WA
98201-1665
US

V. Phone/Fax

Practice location:
  • Phone: 425-304-6165
  • Fax: 425-304-6162
Mailing address:
  • Phone: 425-525-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD00046175
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: