Healthcare Provider Details

I. General information

NPI: 1992612766
Provider Name (Legal Business Name): WILLIAM ANDRADE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 CALLAHAN DRIVE STE C
BREMERTON WA
98310
US

IV. Provider business mailing address

14180 SILVERDALE WAY NW
POULSBO WA
98370-7209
US

V. Phone/Fax

Practice location:
  • Phone: 866-240-0808
  • Fax: 866-240-0809
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: