Anderson, Larry Simon

Anderson, Larry Simon is an individual health care provider with primary practice located at 19020 33Rd Ave W Suite 210, Lynnwood WA 98036-4746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Anderson, Larry Simon can be contacted via phone (425) 563-1500.

Contact Information

Primary practice address
19020 33Rd Ave W Suite 210 Lynnwood WA 98036-4746
Phone: (425) 563-1500
Fax: (425) 563-1374
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD00010119 Washington

Profile Details

NPI number 1215924774
LBN Legal business name Anderson, Larry Simon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Feb 4th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215924774 NPPES
Washington Other 115842 LNI PROVIDER ID
Washington MEDICAID 8197105 LNI PROVIDER ID

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