Provider Demographics
NPI:1740237619
Name:PEET, ANDREW C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:C
Last Name:PEET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11927 SW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-4031
Mailing Address - Country:US
Mailing Address - Phone:206-567-5307
Mailing Address - Fax:
Practice Address - Street 1:11927 SW 148TH ST
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-4031
Practice Address - Country:US
Practice Address - Phone:206-567-5307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025199207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0216866OtherLIWA
WA8201212Medicaid
8946237OtherVICTIMS OF CRIME
WA5570PEOtherBSWA
605960012OtherUSDLAB
WA0227520OtherLIWA
WA3159PEOtherBSWA
605960012OtherFBL
WA1450PEOtherBSWA
WA0227520OtherLIWA
605960012OtherFBL
WAP00395684Medicare PIN
8946237OtherVICTIMS OF CRIME
WA5570PEOtherBSWA
WA1450PEOtherBSWA
WA8201212Medicaid
WAG8859480Medicare PIN