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Individual
MR. ANDREW L STURDIVANT
Active
Individual
MR. ANDREW L STURDIVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004664
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185017
LIWA
WA
01
—
0185018
LIWA
WA
01
—
0185019
LIWA
WA
01
—
1186ST
BSWA
WA
01
—
2164ST
BSWA
WA
01
—
2167ST
BSWA
WA
05
—
8393039
—
WA
05
—
8393381
—
WA
05
—
8803039
—
WA
Enumeration date
06/20/2006
Last updated
08/06/2018
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