Provider Demographics
NPI:1548301104
Name:ANDERSON, DAVID R (PHD TOXICOLOGIST)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PHD TOXICOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 NE 200TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1136
Mailing Address - Country:US
Mailing Address - Phone:206-522-5449
Mailing Address - Fax:206-522-5449
Practice Address - Street 1:1108 NE 200TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-1136
Practice Address - Country:US
Practice Address - Phone:206-522-5449
Practice Address - Fax:206-522-5449
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMicrobiology