Basic Information
| Provider Information | |||||||||
| NPI: | 1720259419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | THERESA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4526 FEDERAL AVE, MS-11 | ||||||||
| Address2: | ATTN: CREDENTIALING | ||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253496200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4526 FEDERAL AVENUE, MS-11 | ||||||||
| Address2: | ATTN: CREDENTIALING | ||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253496200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2008 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | RC00052901 | WA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 175T00000X | 1720259419 | WA | Y |
No ID Information.