Provider Demographics
NPI:1780936336
Name:ANDERSON, STEVEN GRANT (AUD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:GRANT
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2838
Mailing Address - Country:US
Mailing Address - Phone:541-672-8868
Mailing Address - Fax:
Practice Address - Street 1:1367 W HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2838
Practice Address - Country:US
Practice Address - Phone:541-672-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter