Individual
JOHN SCOTT ANDREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15214 CANYON RD E, PUYALLUP, WA 98375-7472
(253) 539-4200
(253) 539-6025
Mailing address
15214 CANYON RD E, PUYALLUP, WA 98375-7472
(253) 539-4200
(253) 539-6025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00025582
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0227517
LIWA
WA
01
—
0291718
L&I
WA
01
—
0291720
L&I
WA
01
—
1450AN
BSWA
WA
01
—
605960013
USDLAB
WA
05
—
8110488
—
WA
01
—
AN5002
BSWA
WA
01
—
G8907495
MEDICARE
WA
Enumeration date
10/25/2006
Last updated
04/23/2012
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