Provider Demographics
NPI:1689187619
Name:BERNHARD, ANDREW CARL (MA, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CARL
Last Name:BERNHARD
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 NE 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5725
Mailing Address - Country:US
Mailing Address - Phone:971-386-3030
Mailing Address - Fax:
Practice Address - Street 1:13413 NE LEROY HAGEN MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5967
Practice Address - Country:US
Practice Address - Phone:360-604-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR016483235Z00000X
CA25755235Z00000X
MT6661235Z00000X
WALL60952061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist