Derek Ryan Anderson, PH.D.
Individual provider Active NPI Clinical Psychologist · Tacoma, WA
NPI 1003364928 · NPPES record last updated Sep 20, 2016
Key facts
- NPI
- 1003364928
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY 60645671 (WA)
- Practice address
- 9600 Veterans Dr SW
Rehabilitation Care Service (a-117-RCS)
Tacoma, WA 98493-0003 - Phone
- (253) 583-1896
- NPI assigned
- Sep 20, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60645671 | WA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 60645671 | WA | Yes |
Addresses
Primary practice location
9600 Veterans Dr SW
Rehabilitation Care Service (a-117-RCS)
Tacoma, WA 98493-0003
Mailing address
9600 Veterans Dr SW
Rehabilitation Care Service (a-117-RCS)
Tacoma, WA 98493-0003
Phone (253) 583-1896
Other providers in Tacoma, WA
- Charles Allen Anderson
- Dae' Janae Anderson
- Dale Anderson
- Dara Elizabeth Anderson
- Dennis Walwyn Anderson
- Elizabeth Mae Anderson
- Emily Jane Anderson
- Gerald W Anderson
- Gregory C Anderson
- Iris Anderson
All providers in Tacoma, WA · Clinical Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.