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General NPI Number Information
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NPI Number | 1346205333
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Entity Type | Individual
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Provider Name | ANGELA N. ANDERSON D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 890 OAK ST SE
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City | SALEM
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State | OR
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Zip | 97301-3905
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Country | US
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Telephone | 503-814-3334
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14001
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City | SALEM
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State | OR
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Zip | 97309-5014
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Country | US
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Telephone |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 47400
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DO27698
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License Number State | OR
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