Healthcare Provider Details

I. General information

NPI: 1386861920
Provider Name (Legal Business Name): ANDY J DUARTE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. ANDY DUARTE

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

2120 N 187TH ST
SHORELINE WA
98133-4238
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-5173
  • Fax: 206-744-5138
Mailing address:
  • Phone: 206-437-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC 60556279
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: