MEDICARE: ANDRA DARLINGTON CDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP 60472462	WA

General Provider Information

NPI Number	:	1023486131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRA DARLINGTON CDP

Provider Business Mailing Address
First Line	:	610 N MISSION ST STE 106
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-6610
Country	:	US
Telephone Number	:	509-888-4404
Fax Number	:	509-888-2741

Provider Business Practice Location Address
First Line	:	610 N MISSION ST STE 106
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-6610
Country	:	US
Telephone Number	:	509-888-4404
Fax Number	:	507-888-2741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	09/04/2015

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