Provider Demographics
NPI:1477267243
Name:MCDUFFIE, ANDREA SWEETMAN (MA, PHD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SWEETMAN
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MADISON AVE S STE 106
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2544
Mailing Address - Country:US
Mailing Address - Phone:206-451-4308
Mailing Address - Fax:206-451-4309
Practice Address - Street 1:330 MADISON AVE S STE 106
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2544
Practice Address - Country:US
Practice Address - Phone:206-451-4308
Practice Address - Fax:206-451-4309
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL61364401235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist