Provider Demographics
NPI:1346480688
Name:ANDREWS, JOHNNIE (OTR)
Entity Type:Individual
Prefix:
First Name:JOHNNIE
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2823 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-3529
Mailing Address - Country:US
Mailing Address - Phone:360-296-6201
Mailing Address - Fax:
Practice Address - Street 1:3121 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1937
Practice Address - Country:US
Practice Address - Phone:360-734-6760
Practice Address - Fax:360-752-0660
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60030717225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist