Provider Demographics
NPI:1306547112
Name:ANDERSON, EMILY JAYNE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JAYNE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 98TH AVE NE STE 104
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4218
Mailing Address - Country:US
Mailing Address - Phone:425-475-1729
Mailing Address - Fax:425-962-3578
Practice Address - Street 1:12006 98TH AVE NE STE 104
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4218
Practice Address - Country:US
Practice Address - Phone:425-475-1729
Practice Address - Fax:425-962-3578
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61416812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor