MEDICARE: JUNE LISA ANDERSON

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
1	390200000X	Student in an Organized Health Care Education/Training Program	RN60521466	WA

General Provider Information

NPI Number	:	1780300624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNE LISA ANDERSON

Provider Business Mailing Address
First Line	:	2309 CRYSTAL SPRINGS RD W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-2822
Country	:	US
Telephone Number	:	310-634-7465
Fax Number	:

Provider Business Practice Location Address
First Line	:	2309 CRYSTAL SPRINGS RD W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-2822
Country	:	US
Telephone Number	:	310-634-7465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	04/13/2026

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Directions to “ JUNE LISA ANDERSON ” Practice Location

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