Provider Demographics
NPI:1255779716
Name:NEWMAN, ANDREW MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18275 SR 410 E STE 101
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6917
Mailing Address - Country:US
Mailing Address - Phone:253-948-2757
Mailing Address - Fax:253-248-0228
Practice Address - Street 1:18275 SR 410 E STE 101
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-6917
Practice Address - Country:US
Practice Address - Phone:253-948-2757
Practice Address - Fax:253-248-0228
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60345251111N00000X
WACH60345251111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor