| Anderson Ent | |
|
718 Ne 87th Ave Vancouver WA 98664-1970 | |
| (360) 828-1346 | |
| (360) 828-7627 |
| Full Name | Anderson Ent |
|---|---|
| Speciality | Clinic/Center |
| Location | 718 Ne 87th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Adrienne B Copple (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 3608281346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anderson Ent 718 Ne 87th Ave Vancouver WA 98664-1970 Ph: (360) 828-1346 | Anderson Ent 718 Ne 87th Ave Vancouver WA 98664-1970 Ph: (360) 828-1346 |
| NPI Number | 1942641584 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 07/11/2013 |
| Medicare PECOS PAC ID | 3577793397 |
|---|---|
| Medicare Enrollment ID | O20140222000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942641584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD00034870 (Washington) | Primary |
| Provider Name | Philemon L Anderson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609836840 PECOS PAC ID: 7810890704 Enrollment ID: I20070219000738 |
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