Provider Demographics
NPI:1659700367
Name:MCANDREWS, SCOTT (LMP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MCANDREWS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:PATRICK
Other - Last Name:MCANDREWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:1430 NE 190TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-2266
Mailing Address - Country:US
Mailing Address - Phone:508-685-2391
Mailing Address - Fax:
Practice Address - Street 1:6325 195TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5143
Practice Address - Country:US
Practice Address - Phone:425-774-6876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60414454225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist