Provider Demographics
NPI:1891429189
Name:ELIASSON, ANDERS (HAS)
Entity Type:Individual
Prefix:
First Name:ANDERS
Middle Name:
Last Name:ELIASSON
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44031 ASHBURN SHOPPING PLZ STE 273
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7919
Mailing Address - Country:US
Mailing Address - Phone:703-291-8400
Mailing Address - Fax:703-291-8404
Practice Address - Street 1:44031 ASHBURN SHOPPING PLZ STE 273
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7919
Practice Address - Country:US
Practice Address - Phone:703-291-8400
Practice Address - Fax:703-291-8404
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101002319237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist