Provider Demographics
NPI:1861183592
Name:ANDERSON, NATHAN TODD (PMHNP)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:TODD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1744 SAPPHIRE TRL
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7838
Mailing Address - Country:US
Mailing Address - Phone:720-206-8522
Mailing Address - Fax:
Practice Address - Street 1:1616 CORNWALL AVE STE 205
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4642
Practice Address - Country:US
Practice Address - Phone:360-676-6177
Practice Address - Fax:360-671-3574
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61410607363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health