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General NPI Number Information
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NPI Number | 1639496052
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Entity Type | Individual
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Provider Name | ANDREA JO KING M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2010
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 505 NE 87TH AVE STE 301
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City | VANCOUVER
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State | WA
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Zip | 98664-1965
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Country | US
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Telephone | 360-514-1854
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Fax | 360-514-6063
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Provider Business Mailing Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone |
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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 | 2086H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Surgery) Physician
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License Number | MD60647438
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD60647438
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60647438
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License Number State | WA
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