Healthcare Provider Details

I. General information

NPI: 1326207051
Provider Name (Legal Business Name): ANDREW JAMES PASTOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21401 72ND AVE W
EDMONDS WA
98026-7702
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-412-1875
  • Fax: 425-304-1103
Mailing address:
  • Phone: 206-860-5414
  • Fax: 206-720-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD60340743
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: