Street, Andrea K.
Street, Andrea K. is an individual health care provider with primary practice located at 600 Broadway St , Longview WA 98632-3256. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Street, Andrea K. can be contacted via phone (360) 636-4943.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X |
Profile Details
| NPI number | 1679745624 |
|---|---|
| LBN Legal business name | Street, Andrea K. |
| Credentials | B.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2008 |
| Last updated | Dec 20th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679745624 | NPPES |
| Washington | MEDICAID | 8510075 |
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