Anthony D Anderson, LMP,PTA
Individual provider Active NPI Massage Therapist · Milwaukie, OR
NPI 1922108992 · NPPES record last updated May 19, 2010
Key facts
- NPI
- 1922108992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00019881 (WA)
- Practice address
- 4560 SE International Way Ste 100
Milwaukie, OR 97222-4628 - Phone
- (971) 206-5166
- Fax
- (971) 206-5211
- NPI assigned
- Sep 22, 2006
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00019881 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00019881 | WA | Yes |
Addresses
Primary practice location
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Mailing address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone (971) 206-5166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0189046 | Other | WA | LABOR AND INDUSTRIES |
Other providers in Milwaukie, OR
- Kimberly Kay Amayao
- Erin Amick
- Paula Jean Amyx
- Anahata Acupuncture NW
- Anahata Medicine
- Brian Edward Anderson
- Corinne J Anderson
- Corrie Ann Anderson
- Ellen Irene Anderson
- Linda Joy Anderson
All providers in Milwaukie, OR · Massage Therapist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2010. 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.