Healthcare Provider Details

I. General information

NPI: 1831043702
Provider Name (Legal Business Name): ANDREA QUARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7985 VANCE DR STE 206
ARVADA CO
80003-2120
US

IV. Provider business mailing address

105 HEMLOCK ST
BROOMFIELD CO
80020-2206
US

V. Phone/Fax

Practice location:
  • Phone: 720-390-8580
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0027223
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: