Provider Demographics
NPI:1285244095
Name:ANDERSON, HOWARD JAVIER PERRY
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:JAVIER PERRY
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6129 73RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-9041
Mailing Address - Country:US
Mailing Address - Phone:206-708-0235
Mailing Address - Fax:
Practice Address - Street 1:6129 73RD AVE NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-9041
Practice Address - Country:US
Practice Address - Phone:206-708-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC55986171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter