Healthcare Provider Details

I. General information

NPI: 1629040480
Provider Name (Legal Business Name): DAVID ANDREW PHILIPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 192ND AVE STE 100
CAMAS WA
98607-6505
US

IV. Provider business mailing address

2773 HARRIS ST STE A
EUREKA CA
95503-4866
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-1965
  • Fax:
Mailing address:
  • Phone: 707-442-1182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number27249
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number21924
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA116515
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD2008-0665
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number27249
License Number StateMT
# 6
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD60899262
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: