David Anderson, STUDENT

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Forest Grove, OR

NPI 1508220955 · NPPES record last updated Apr 12, 2016

Key facts

NPI
1508220955
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
2043 College Way
Forest Grove, OR 97116-1756
Phone
(208) 360-3968
NPI assigned
Apr 12, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OR Yes

Addresses

Primary practice location

2043 College Way
Forest Grove, OR 97116-1756

Mailing address

2043 College Way
Forest Grove, OR 97116-1756

Other providers in Forest Grove, OR

All providers in Forest Grove, OR · Student in an Organized Health Care Education/Training Program in Oregon

Sources for this page

Verify at the official NPI Registry.