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NPI Code Detail

MEDICARE: DR. STEPHANIE ANN MCANDREW MD

MEDICARE: DR. STEPHANIE ANN MCANDREW MD
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
1207Q00000XFamily Medicine PhysicianMD28315OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508879677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE ANN MCANDREW MD
Provider Business Mailing Address
First Line : PO BOX 6149
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-0149
Country : US
Telephone Number : 503-352-8657
Fax Number : 503-352-8658
Provider Business Practice Location Address
First Line : 12710 SE DIVISION ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-3134
Country : US
Telephone Number : 503-988-3601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 08/20/2018

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