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General NPI Number Information
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NPI Number | 1154432912
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Entity Type | Individual
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Provider Name | ANDRA C. DEVOGHT PT, MPH
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 17641 VASHON HWY SW
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City | VASHON
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State | WA
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Zip | 98070
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Country | US
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Telephone | 206-953-1133
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Fax | 844-666-7401
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Provider Business Mailing Address
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Address Line | PO BOX 2537
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City | VASHON
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State | WA
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Zip | 98070-2537
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Country | US
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Telephone | 206-953-1133
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Fax | 844-666-7401
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00006730
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License Number State | WA
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