Provider Demographics
NPI:1376166876
Name:LAFFIE, ANDREW D (CADC L)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:LAFFIE
Suffix:
Gender:M
Credentials:CADC L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0160
Mailing Address - Country:US
Mailing Address - Phone:541-240-8740
Mailing Address - Fax:541-240-8754
Practice Address - Street 1:46314 TIMINE WAY
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9417
Practice Address - Country:US
Practice Address - Phone:541-240-8740
Practice Address - Fax:541-240-8754
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-12-10101YA0400X
OR23-QMHA-R-4616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)