Provider Demographics
NPI:1942671672
Name:ROWE, ANDREA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 W MAPLEWOOD AVE APT 223
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8888
Mailing Address - Country:US
Mailing Address - Phone:360-733-6373
Mailing Address - Fax:
Practice Address - Street 1:2715 W MAPLEWOOD AVE APT 223
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-8888
Practice Address - Country:US
Practice Address - Phone:360-733-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160446833225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant