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General NPI Number Information
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NPI Number | 1497804546
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Entity Type | Individual
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Provider Name | ANDREW K HEINTZ MSW
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 213 BENDIGO BLVD N SUITE 1
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City | NORTH BEND
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State | WA
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Zip | 98045-8259
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Country | US
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Telephone | 425-888-5130
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Fax | 425-888-5139
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Provider Business Mailing Address
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Address Line | 9450 ETHAN WADE WAY SE SUITE B
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City | SNOQUALMIE
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State | WA
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Zip | 98065-9520
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Country | US
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Telephone | 425-831-2300
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Fax | 425-831-2361
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW00006467
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License Number State | WA
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