Provider Demographics
NPI:1386861920
Name:DUARTE, ANDY J (MSW)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:J
Last Name:DUARTE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:DUARTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2120 N 187TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4238
Mailing Address - Country:US
Mailing Address - Phone:206-437-7955
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-5173
Practice Address - Fax:206-744-5138
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WASC 60556279104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor