Provider Demographics
NPI:1568688562
Name:MCCRADY, ANDREA MERCER (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MERCER
Last Name:MCCRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16506 N WEST SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NINE MILE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99026-9626
Mailing Address - Country:US
Mailing Address - Phone:509-467-9421
Mailing Address - Fax:
Practice Address - Street 1:322 W NORTH RIVER DRIVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2259
Practice Address - Country:US
Practice Address - Phone:509-324-6464
Practice Address - Fax:509-324-3715
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine