# MR. ANDREW L STURDIVANT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1982640025
- **Gender:** Man
- **Credential:** PA C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004664 | WA | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 08/06/2018

## 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 |