Provider Demographics
NPI:1013936343
Name:FRIEDMAN, ANDREW S (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:FRIEDMAN
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 1:1100 9TH AVE
Mailing Address - Street 2:M/S: M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-583-6025
Mailing Address - Fax:206-515-5886
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6999
Practice Address - Fax:206-625-7278
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031061208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8181455Medicaid
AKMD6103Medicaid
WA206033OtherLABOR AND INDUSTRIES
WA805441900OtherIDAHO MEDICAID
WAMD6103OtherALASKA MEDICAID
WAUS0862704OtherAETNA/USHC SPECIALIST
990005755OtherRAILROAD MEDICARE
WA0039622OtherLABOR & INDUSTRY
ID805441900Medicaid
WAFR5117OtherBLUE SHIELD
WA206033OtherLABOR AND INDUSTRIES
WAFR5117OtherBLUE SHIELD
G17672Medicare UPIN