MEDICARE: MS. VALERIE KIM ANDERSON DPT

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	225100000X	Physical Therapist	PT00010113	WA

General Provider Information

NPI Number	:	1902006505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALERIE KIM ANDERSON DPT

Provider Business Mailing Address
First Line	:	1895 N WILLAMETTE RD
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99016-5060
Country	:	US
Telephone Number	:	509-389-1272
Fax Number	:	509-413-1673

Provider Business Practice Location Address
First Line	:	12012 E MISSION AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4887
Country	:	US
Telephone Number	:	509-413-1630
Fax Number	:	509-413-1673

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

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	10/18/2013

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