Provider Demographics
NPI:1225454705
Name:WINSTEAD, ANDREW (CDP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:WINSTEAD
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S GRADY WAY STE LL25
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3218
Mailing Address - Country:US
Mailing Address - Phone:425-291-7581
Mailing Address - Fax:
Practice Address - Street 1:15 S GRADY WAY STE LL25
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3218
Practice Address - Country:US
Practice Address - Phone:425-291-7581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-08
Last Update Date:2014-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00002742101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor