Provider Demographics
NPI:1306391651
Name:CAOILE, ANDY JAY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:JAY
Last Name:CAOILE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 NE 151ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-4712
Mailing Address - Country:US
Mailing Address - Phone:808-372-9968
Mailing Address - Fax:
Practice Address - Street 1:809 NE 151ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-4712
Practice Address - Country:US
Practice Address - Phone:808-372-9968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other