Provider Demographics
NPI:1477160042
Name:ANDERSON, AARYN EDITH (LADC)
Entity Type:Individual
Prefix:
First Name:AARYN
Middle Name:EDITH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:AARYN
Other - Middle Name:EDITH
Other - Last Name:BHATTARAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920 100TH ST SE STE A2
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3832
Mailing Address - Country:US
Mailing Address - Phone:425-312-0268
Mailing Address - Fax:
Practice Address - Street 1:1920 100TH ST SE STE A2
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3832
Practice Address - Country:US
Practice Address - Phone:425-312-0268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305584101YA0400X
WAMC61189177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)