Provider Demographics
NPI:1174507610
Name:ANDERSON, STEVEN F (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:F
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 134TH ST SW STE 140
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7314
Mailing Address - Country:US
Mailing Address - Phone:425-835-5830
Mailing Address - Fax:425-835-4212
Practice Address - Street 1:802 134TH ST SW STE 140
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-7314
Practice Address - Country:US
Practice Address - Phone:425-835-5830
Practice Address - Fax:425-835-4212
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10718415-1701183500000X
WAPH00010939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist