Healthcare Provider Details

I. General information

NPI: 1487569927
Provider Name (Legal Business Name): TRINA DEE ANDREW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 540
WELLPINIT WA
99040-0540
US

IV. Provider business mailing address

PO BOX 540
WELLPINIT WA
99040-0540
US

V. Phone/Fax

Practice location:
  • Phone: 509-606-2764
  • Fax:
Mailing address:
  • Phone: 509-606-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPST.PE.70093461
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: