Healthcare Provider Details

I. General information

NPI: 1104261874
Provider Name (Legal Business Name): ANDREW PHILIP COVINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW STE 404
BURIEN WA
98166-3059
US

IV. Provider business mailing address

16259 SYLVESTER RD SW STE 404
BURIEN WA
98166-3059
US

V. Phone/Fax

Practice location:
  • Phone: 206-243-3049
  • Fax: 206-965-4199
Mailing address:
  • Phone: 206-243-3049
  • Fax: 206-965-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD60788009
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5499181-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR73802
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: