Provider Demographics
NPI:1114990975
Name:PERRY, ANDREW KNUBEL (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:KNUBEL
Last Name:PERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:21710 76TH AVE W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7510
Mailing Address - Country:US
Mailing Address - Phone:425-640-5500
Mailing Address - Fax:425-640-5520
Practice Address - Street 1:21710 76TH AVE W
Practice Address - Street 2:SUITE 300
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7510
Practice Address - Country:US
Practice Address - Phone:425-640-5500
Practice Address - Fax:425-640-5520
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD 60107002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2287592OtherAETNA
MD00000008292OtherBMC HEALTHNET
MA767000OtherSECURE HORIZONS
MA4313693OtherCIGNA
MA767000OtherTUFTS HEALTH PLAN
MASBH066OtherHARVARD PILGRIM
MA0002233OtherNEIGHBORHOOD HEALTH PLAN
MAJ17598OtherBLUE CROSS
MA767000OtherTUFTS HEALTH PLAN
MAG41963Medicare UPIN