Provider Demographics
NPI:1043788532
Name:DUPLANTIS, ANDREW STEVEN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEVEN
Last Name:DUPLANTIS
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 1:222 WALL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1431
Mailing Address - Country:US
Mailing Address - Phone:206-441-3043
Mailing Address - Fax:206-441-4155
Practice Address - Street 1:222 WALL ST STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1431
Practice Address - Country:US
Practice Address - Phone:206-441-3043
Practice Address - Fax:206-441-4155
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60539222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health