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General NPI Number Information
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NPI Number | 1043163983
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Entity Type | Individual
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Provider Name | DESARAY ANDEXLER
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Gender |
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 4949 NE ST JOHNS RD APT 51
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City | VANCOUVER
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State | WA
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Zip | 98661-2539
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Country | US
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Telephone | 971-285-0412
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Fax |
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Provider Business Mailing Address
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Address Line | 3729 KLINDT DR
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City | THE DALLES
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State | OR
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Zip | 97058-3566
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Country | US
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Telephone | 541-298-2101
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Fax | 541-298-7996
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OR
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