Provider Demographics
NPI:1134169261
Name:ANDERSON, ELIZABETH MAE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MAE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
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Other - Last Name:
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Mailing Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-4843
Mailing Address - Fax:253-968-6668
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4816
Practice Address - Country:US
Practice Address - Phone:253-968-4843
Practice Address - Fax:253-968-6668
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY6002103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent