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General NPI Number Information
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NPI Number | 1770665309
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Entity Type | Individual
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Provider Name | GERALD W ANDERSON MD
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 3315 SO 23 #200
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-627-0114
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Fax | 253-627-0498
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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 | 253-627-0114
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Fax | 253-627-0498
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD00015029
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License Number State | WA
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