Individual
ANDREW WODKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS,PT, MBA
Contact information
Practice address
100 DENNIS ST SW, SUITE A, TUMWATER, WA 98501-6523
(360) 704-3300
(360) 704-7676
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009524
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192512
DEPT OF LABOR & INDUSTRY
WA
01
—
3757WO
REGENCE BLUE SHIELD
WA
05
—
8413882
—
WA
01
—
8939766
CRIME VICTIMS
WA
01
—
P00208864
RAILROAD MEDICARE
WA
Enumeration date
11/15/2006
Last updated
07/18/2015
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