Provider Demographics
NPI:1093863219
Name:THURMAN, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:THURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14841 179TH AVE SE STE 210
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1127
Mailing Address - Country:US
Mailing Address - Phone:360-217-1155
Mailing Address - Fax:360-217-1154
Practice Address - Street 1:14841 179TH AVE SE STE 210
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1127
Practice Address - Country:US
Practice Address - Phone:360-217-1155
Practice Address - Fax:360-217-1154
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00037230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8222531Medicaid
WA8222531Medicaid
WAGAB22721Medicare PIN