1205887056 NPI number — CHRISTOPHER GEORGE ANDERSON M.D.

Table of content: (NPI 1831468057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205887056 NPI number — CHRISTOPHER GEORGE ANDERSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
CHRISTOPHER
Provider Middle Name:
GEORGE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205887056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12410 EAST SINTO
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-928-4334
Provider Business Mailing Address Fax Number:
509-928-7893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12410 E SINTO AVE STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-2280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-4334
Provider Business Practice Location Address Fax Number:
509-928-7893
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  MD00046103 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X , with the licence number: MD00046103 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0155873 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3131AN . This is a "ASURIS NW HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8449464 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3131AN . This is a "ASURIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G8860150 . This is a "MEDICARE WA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 807413200 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00346484 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0206858 . This is a "DEPT OF LABOR & INDUSTRIE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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