Healthcare Provider Details

I. General information

NPI: 1174204101
Provider Name (Legal Business Name): MAGDA ANDRAWS MA, LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11017 NE 194TH DR
BOTHELL WA
98011-3007
US

IV. Provider business mailing address

11017 NE 194TH DR
BOTHELL WA
98011-3007
US

V. Phone/Fax

Practice location:
  • Phone: 206-920-4039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61282829
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: