Provider Demographics
NPI:1720437619
Name:STUMP, ANDREA (ATC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:STUMP
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8821 N HILL N DALE ST
Mailing Address - Street 2:APT 12
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8821 N HILL N DALE ST
Practice Address - Street 2:APT 12
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1100
Practice Address - Country:US
Practice Address - Phone:719-433-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer