Provider Demographics
NPI:1407971237
Name:MURRAY, ANDREW K (DPD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:K
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23416 HWY99
Mailing Address - Street 2:D
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:425-672-1400
Mailing Address - Fax:425-672-1408
Practice Address - Street 1:23416 HIGHWAY 99
Practice Address - Street 2:SUITE D
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-9328
Practice Address - Country:US
Practice Address - Phone:425-672-1400
Practice Address - Fax:425-672-1408
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN00000359122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5045125Medicaid
1295802080OtherNPI FOR ORGANIZATION