Individual provider · Type 1 NPI
Tyler Lee Anderson, PA-C
Medical Physician Assistant · Clarkston, WA
NPI number
1083927792
Active
Practice location
1119 Highland Ave Ste 4
Clarkston, WA 99403-2836
Fax (509) 254-0079
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA10003435 (WA) |
Medical Physician Assistant: Definition to come...
Another provider at this address
About NPI 1083927792
Tyler Lee Anderson, PA-C's National Provider Identifier is 1083927792, issued on Jul 22, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Clarkston, WA. The record was last updated on Jul 22, 2010.