Provider Demographics
NPI:1043988017
Name:BROERING, ANDREW ROBERT (CO 61171970)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:BROERING
Suffix:
Gender:M
Credentials:CO 61171970
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 W DESCHUTES PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7719
Mailing Address - Country:US
Mailing Address - Phone:509-579-0783
Mailing Address - Fax:509-579-0712
Practice Address - Street 1:7510 W DESCHUTES PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7719
Practice Address - Country:US
Practice Address - Phone:509-579-0738
Practice Address - Fax:509-579-0712
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)