Provider Demographics
NPI:1457393654
Name:ANDERSON, RICHARD DON (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DON
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3197
Mailing Address - Country:US
Mailing Address - Phone:509-962-8008
Mailing Address - Fax:509-962-8009
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3197
Practice Address - Country:US
Practice Address - Phone:509-962-8008
Practice Address - Fax:509-962-8009
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3616111N00000X
WACH00034692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor