MICHAEL R ANDERSON (NPI# 1497740575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497740575 |
| Entity Type | Individual |
| Full Name | MICHAEL R ANDERSON |
| Credential | MD |
| Practice Address |
4011 Talbot Rd S #220 Renton WA 98055-5791 |
| Practice Telephone | 4256565300 |
| Practice Fax Number | 4256565402 |
| Mailing Telephone | 4256565300 |
| Mailing Fax Number | 4256565402 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
MD00014404 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | REGENCE | AN6847 | 01 |
| WA | 1094895 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598374712 | Michael Richard Anderson | Clinic/Center | 2560 Hubbell Ave, Des Moines, IA 50317-6102 | 2020-07-23 |
| 1881234623 | Michael Anderson | Durable Medical Equipment & Medical Supplies | 1203 N Hobart St Ste 34, Pampa, TX 79065-4664 | 2020-01-09 |
| 1164920898 | Michael Anderson | Counselor | 502 Mccarty Ln Ste 5, Jackson, OH 45640-7025 | 2018-01-29 |
| 1609324789 | Michael Anderson | Counselor | 75 Heaton Dr, Covington, GA 30016-0224 | 2016-09-16 |
| 1629438437 | Michael Anderson | Counselor | 145 Yonker Street, Barbeton, OH 44203 | 2016-03-07 |
| 1124406186 | Michael A Anderson | Family Medicine | 1000 Pocatello Creek Rd Ste E10, Pocatello, ID 83201-2953 | 2015-05-11 |
| 1679971683 | Michael Anderson | Occupational Therapist | 355 Saddlebrook Cir, Lewisville, NC 27023-8213 | 2014-12-08 |
| 1881004877 | Michael Anderson | Anesthesiology | 2345 E Thomas Rd Ste 400, Phoenix, AZ 85016 | 2014-04-30 |
| 1467871517 | Michael Callum Anderson | Counselor | 1881 Ne 26th St Ste 70, Wilton Manors, FL 33305-1425 | 2014-04-15 |
| 1871911958 | Michael Anderson | Physical Therapist | 9909 Mira Mesa Blvd Ste 260, San Diego, CA 92131-1064 | 2014-04-04 |
| Street Address |
4011 TALBOT RD S #220 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061694 | Guy V Buell | Specialist | 4011 Talbot Rd S, Ste 440, Renton, WA 98055-5791 | 2005-05-23 |
| 1649756883 | Amy Elizabeth Hardiman | Physical Therapy Assistant | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2018-07-11 |
| 1336665959 | Mary Elizabeth Walton | Dietitian, Registered | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2017-08-15 |
| 1548791924 | Southlake Select, PC | Point of Service | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 | 2017-03-27 |
| 1871031864 | Abrey Lee | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1962940957 | Kimberly Diana Konczak | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1578931325 | Andrew S Huntley | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2015-09-10 |
| 1285011080 | Anne Macleod | Registered Nurse | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2015-04-30 |
| 1508263716 | Mie Hagiwara | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-12-03 |
| 1073921813 | Zachary A. Bowman | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063628576 | Valley Children's Clinic | Pediatrics | 4011 Talbot Rd S Ste 220, Renton, WA 98055-5791 | 2007-05-15 |
| 1457346520 | David M Christopher | Pediatrics | 4011 Talbot Rd S, Suite 220, Renton, WA 98055-5791 | 2005-09-15 |
| 1447245519 | Monica Richter | Pediatrics | 4011 Talbot Rd S, Suite 220, Renton, WA 98055-5791 | 2005-09-15 |
| 1356336424 | Gary H German | Pediatrics | 4011 Talbot Rd S, Renton, WA 98055-5791 | 2005-09-15 |
| 1174518245 | Graciela Del Rio | Pediatrics | 4011 Talbot Rd S, Renton, WA 98055-5791 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720498280 | Rainier Pediatrics, Inc | Pediatrics | 12904 94th Ave E, Puyallup, WA 98373-5538 | 2014-05-05 |
| 1568675544 | Robert Michael Lehman | Pediatrics | 1545 Nw 57th St, #522, Seattle, WA 98107-5643 | 2007-05-07 |
| 1134343676 | Michael Donlan | Pediatrics | 7103 N Skyline Dr, Spokane, WA 99208-6717 | 2007-04-13 |
| 1508927062 | David Alan Springer | Pediatrics | 4005 Wallingford Ave N, Seattle, WA 98103-8218 | 2006-12-12 |
| 1730247073 | Mohinder Singh Badyal | Pediatrics | 32124 1st Ave S, Ste100, Federal Way, WA 98003-5761 | 2006-12-05 |
| 1396813218 | Penny Russell Tronolone | Pediatrics | Echo Glen Children's Center, 33010 Se 99th St, Snoqualmie, WA 98065 | 2006-11-30 |
| 1164508792 | Deborah J Ayars | Pediatrics | 1901 S Union Ave Ste B1010, Tacoma, WA 98405-1801 | 2006-10-27 |
| 1922027168 | Tania Milad Matta | Pediatrics | 3950 Keene Road, West Richland, WA 99353 | 2006-07-19 |
| 1629025333 | Public Hospital District #1 of King County | Pediatrics | 6920 Coal Creek Pkwy Se, Ste 12, Newcastle, WA 98059-3147 | 2006-05-28 |
| 1861468720 | Gina Suzanne Sucato | Pediatrics | 13451 Se 36th St, Bellevue, WA 98006-1475 | 2006-02-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.