Provider Demographics
NPI:1497804546
Name:HEINTZ, ANDREW K (MSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:K
Last Name:HEINTZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 ETHAN WADE WAY SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9520
Mailing Address - Country:US
Mailing Address - Phone:425-831-2300
Mailing Address - Fax:425-831-2361
Practice Address - Street 1:213 BENDIGO BLVD N
Practice Address - Street 2:SUITE 1
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8259
Practice Address - Country:US
Practice Address - Phone:425-888-5130
Practice Address - Fax:425-888-5139
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000064671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW00006467OtherSTATE LICENSE