Provider Demographics
NPI:1790174209
Name:HARTMAN, ANDREA N R (PSYD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:N R
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SEATTLE CHILDREN'S HOSPITAL
Mailing Address - Street 2:4800 SAND POINT WAY NE, MS OA.5.154
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-987-2164
Mailing Address - Fax:
Practice Address - Street 1:SEATTLE CHILDREN'S HOSPITAL
Practice Address - Street 2:4800 SAND POINT WAY NE, MS OA.5.154
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-987-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 390200000X
WAPY60881065103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program