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NPI Code Detail

MEDICARE: JERRY M ANDERSON JR. MD

MEDICARE: JERRY M ANDERSON JR. MD
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
1207V00000XObstetrics & Gynecology PhysicianMD60481560WA
2207V00000XObstetrics & Gynecology PhysicianL5224TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38F8791OTHERTXBCBS
4133275100OTHERTXFIRST CARE

General Provider Information

NPI Number : 1356351688
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY M ANDERSON JR. MD
Provider Business Mailing Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number : 877-515-2975
Provider Business Practice Location Address
First Line : 201 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5226
Country : US
Telephone Number : 206-326-3000
Fax Number : 877-515-2975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 03/11/2026

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