Provider Demographics
NPI:1124538962
Name:EMDE, ANDREA L (ND, DC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:EMDE
Suffix:
Gender:F
Credentials:ND, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 HWY 93 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937
Mailing Address - Country:US
Mailing Address - Phone:406-862-9700
Mailing Address - Fax:
Practice Address - Street 1:5875 HWY 93 S
Practice Address - Street 2:SUITE A
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-862-9700
Practice Address - Fax:406-862-9701
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61091874111N00000X
MT7356111N00000X
WA60807235175F00000X
MT2355175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractor