Andrew Shannon Neff
Individual provider Active NPI Clinical Child & Adolescent Psychologist · Clinton, WA
NPI 1124104484 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124104484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- License
- RC00055231 (WA)
- Practice address
- 4139 Beachmont Dr.
Clinton, WA 98236-8411 - Phone
- (360) 341-1443
- NPI assigned
- Oct 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00055231 | WA | MD | Clinical Child & Adolescent Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | RC00055231 | WA | Yes |
Addresses
Primary practice location
4139 Beachmont Dr.
Clinton, WA 98236-8411
Mailing address
4139 Beachmont Dr.
Clinton, WA 98236-8411
Phone (360) 341-1443
Other providers in Clinton, WA
- Jeffrey Paul Lagasse
- Joanne L Leblanc
- William Robert Loscher
- Lisa Ruth Mitchell
- Gloria Ann Moore
- Crystal Ogle
- Brittany Ann Olsen-Boblitt
- Kristin L Penn
- Robert William Perkins
- Pillar Physical Therapy LLC
All providers in Clinton, WA · Clinical Child & Adolescent Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.