Provider Demographics
NPI:1174645691
Name:DUFFIELD, ANDREA LEAH
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEAH
Last Name:DUFFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13627 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2104
Mailing Address - Country:US
Mailing Address - Phone:206-331-2659
Mailing Address - Fax:
Practice Address - Street 1:13010 NE 20TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2034
Practice Address - Country:US
Practice Address - Phone:425-644-6328
Practice Address - Fax:425-644-6295
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist