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General NPI Number Information
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NPI Number | 1366022568
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Entity Type | Individual
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Provider Name | ANDREW AUGUST WINGERSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 1550 NORTH 115TH STREET BOX 358828
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City | SEATTLE
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State | WA
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Zip | 98133-9733
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Country | US
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Telephone | 206-920-9183
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 10TH AVE N
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City | BILLINGS
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State | MT
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Zip | 59101-0720
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Country | US
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Telephone | 406-657-3952
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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