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NPI Code Detail

MEDICARE: STEPHEN EDWARD ANDERSON PHYSICAL THERAPIST

MEDICARE: STEPHEN EDWARD ANDERSON PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00002911WA
2225100000XPhysical Therapist1017OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114901147
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN EDWARD ANDERSON PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 11481 SW HALL BLVD
Second Line : THERAPEUTIC ASSOCIATES INC STE 201
City : PORTLAND
State : OR
Zip : 97223-8403
Country : US
Telephone Number : 800-219-8835
Fax Number : 503-443-1402
Provider Business Practice Location Address
First Line : 4701 41ST AVE SW
Second Line : TAI WEST SEATTLE PHYSICAL THERAPY STE 100
City : SEATTLE
State : WA
Zip : 98116-4597
Country : US
Telephone Number : 206-932-8363
Fax Number : 206-932-4973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 07/08/2007

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Directions to “ STEPHEN EDWARD ANDERSON PHYSICAL THERAPIST” Practice Location

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