Provider Demographics
NPI:1619030509
Name:BUMP, ANDREA CHRISTIN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CHRISTIN
Last Name:BUMP
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-5117
Mailing Address - Country:US
Mailing Address - Phone:360-319-5286
Mailing Address - Fax:
Practice Address - Street 1:3201 NORTHWEST AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1363
Practice Address - Country:US
Practice Address - Phone:360-319-5286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021889225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3858UPOtherREGENCE
WA212889OtherL&I