Basic Information
| Provider Information | |||||||||
| NPI: | 1013936343 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 9TH AVE | ||||||||
| Address2: | M/S: M4-PFS | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065836025 | ||||||||
| FaxNumber: | 2065155886 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062236999 | ||||||||
| FaxNumber: | 2066257278 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 06/23/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD00031061 | WA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 8181455 | 05 | WA | MEDICAID | MD6103 | 05 | AK | MEDICAID | 206033 | 01 | WA | LABOR AND INDUSTRIES | OTHER | 805441900 | 01 | WA | IDAHO MEDICAID | OTHER | MD6103 | 01 | WA | ALASKA MEDICAID | OTHER | US0862704 | 01 | WA | AETNA/USHC SPECIALIST | OTHER | 990005755 | 01 | RAILROAD MEDICARE | OTHER | 0039622 | 01 | WA | LABOR & INDUSTRY | OTHER | 805441900 | 05 | ID | MEDICAID | FR5117 | 01 | WA | BLUE SHIELD | OTHER |