Provider Demographics
NPI:1073849923
Name:GUDWIN, ANDREW D (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:D
Last Name:GUDWIN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3974
Mailing Address - Country:US
Mailing Address - Phone:305-582-3090
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:HARBORVIEW MEDICAL CENTER BOX 359799
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-3090
Practice Address - Fax:206-744-8649
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60108691363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health