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NPI Code Detail

MEDICARE: ANDREW GROSSMAN ARNP

MEDICARE:   ANDREW  GROSSMAN  ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerAP60282819WA

General Provider Information

NPI Number : 1134483266
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW GROSSMAN ARNP
Provider Business Mailing Address
First Line : 5223 KENSINGTON PL N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-6225
Country : US
Telephone Number : 206-498-0453
Fax Number :
Provider Business Practice Location Address
First Line : 5223 KENSINGTON PL N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-6225
Country : US
Telephone Number : 206-498-0453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2012
Last Update Date : 07/03/2012

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