Basic Information
| Provider Information | |||||||||
| NPI: | 1629113303 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | STANLEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 N. 107TH ST. | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981339009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066292186 | ||||||||
| FaxNumber: | 2064208393 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 N. 107TH ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981339009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066292186 | ||||||||
| FaxNumber: | 2064208393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 08/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175F00000X | NT00001504 | WA | Y | Other Service Providers | Naturopath |
No ID Information.