Provider Demographics
NPI:1205887056
Name:ANDERSON, CHRISTOPHER GEORGE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12410 EAST SINTO
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-928-4334
Mailing Address - Fax:509-928-7893
Practice Address - Street 1:12410 E SINTO AVE STE 201
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2280
Practice Address - Country:US
Practice Address - Phone:509-928-4334
Practice Address - Fax:509-928-7893
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046103207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00346484OtherRR MEDICARE
MT0155873Medicaid
ID807413200Medicaid
3131ANOtherASURIS
WA8449464Medicaid
WAG8860150OtherMEDICARE WA
WA0206858OtherDEPT OF LABOR & INDUSTRIE
3131ANOtherASURIS NW HEALTH
ID807413200Medicaid
MT0155873Medicaid
WA8449464Medicaid