Provider Demographics
NPI:1588828859
Name:SCHLUSSEL, ANDREW TODD (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:TODD
Last Name:SCHLUSSEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11307 BRIDGEPORT WAY SW STE 220A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3024
Mailing Address - Country:US
Mailing Address - Phone:253-985-2733
Mailing Address - Fax:253-207-4240
Practice Address - Street 1:11307 BRIDGEPORT WAY SW STE 220A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3024
Practice Address - Country:US
Practice Address - Phone:253-985-2733
Practice Address - Fax:253-207-4240
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1320208C00000X, 208D00000X
WAOP60653386208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2080417Medicaid
VAD000OtherUPIN