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General NPI Number Information
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NPI Number | 1043309362
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Entity Type | Individual
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Provider Name | CHRISTOPHER FREDRIC ANDERSON M.S.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1601 E FOURTH PLAIN BLVD V3 SATP
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City | VANCOUVER
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State | WA
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Zip | 98661-3753
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Country | US
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Telephone | 503-220-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 NE 84TH AVE
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City | PORTLAND
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State | OR
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Zip | 97220-5238
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Country | US
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Telephone | 503-220-8262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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