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General NPI Number Information
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NPI Number | 1710493663
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Entity Type | Organization
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Legal Business Name | GERALD W ANDERSON, M.D.P.S.
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 12/14/2017
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Provider Practice Location Address
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Address Line | 315 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-4234
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Country | US
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Telephone | 253-552-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3725 123RD STREET CT NW
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City | GIG HARBOR
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State | WA
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Zip | 98332-8904
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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 | PHYSICIAN
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Name | GERALD W ANDERSON
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Credential |
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Telephone | 253-848-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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