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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215924774 | NPPES |
| Washington | Other | 115842 | LNI PROVIDER ID |
| Washington | MEDICAID | 8197105 | LNI PROVIDER ID |
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