1427023670 NPI number — MRS. DENISE ANDERSEN HEALTH SERVICE TECH

Table of content: MRS. DENISE ANDERSEN HEALTH SERVICE TECH (NPI 1427023670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427023670 NPI number — MRS. DENISE ANDERSEN HEALTH SERVICE TECH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSEN
Provider First Name:
DENISE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
HEALTH SERVICE TECH
Provider Gender Code:
F

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:
1427023670
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
USCGC HEALY WAGB 20
Provider Second Line Business Mailing Address:
1519 ALASKAN WAY SOUTH
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
98134-1192
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-217-6300
Provider Business Mailing Address Fax Number:
206-217-6309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USCGC HEALY WAGB 20
Provider Second Line Business Practice Location Address:
1519 ALASKAN WAY SOUTH
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
98134-1192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-217-6300
Provider Business Practice Location Address Fax Number:
206-217-6309
Provider Enumeration Date:
02/21/2006

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: 247200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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