Healthcare Provider Details

I. General information

NPI: 1801748504
Provider Name (Legal Business Name): ANDRIA MARSHALL HEDGEPETH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 DELAWARE ST
LONGVIEW WA
98632-2367
US

IV. Provider business mailing address

6817 NE 69TH AVE
VANCOUVER WA
98661-1673
US

V. Phone/Fax

Practice location:
  • Phone: 360-414-2000
  • Fax:
Mailing address:
  • Phone: 360-977-3317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70113072
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10019225
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001459-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: