Provider Demographics
NPI:1912676206
Name:SHERK, ANDREW DALE
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:DALE
Last Name:SHERK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W STATE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-6140
Mailing Address - Country:US
Mailing Address - Phone:360-660-6336
Mailing Address - Fax:
Practice Address - Street 1:403 W STATE ST STE 206
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6140
Practice Address - Country:US
Practice Address - Phone:360-660-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health