Provider Demographics
NPI:1932307972
Name:WRIGHT, ANDREW SCOTT (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:SCOTT
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:S
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT, ATC
Mailing Address - Street 1:6703 W RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2623
Mailing Address - Country:US
Mailing Address - Phone:509-460-5588
Mailing Address - Fax:509-783-5438
Practice Address - Street 1:965 GOETHALS
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7623
Practice Address - Country:US
Practice Address - Phone:509-460-5588
Practice Address - Fax:509-783-5438
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8494155Medicaid
WA224806OtherLABOR & INDUSTRIES
WAP0064479OtherRR MEDICARE
WAG8869998Medicare PIN