Kevin R Andrews, MD
Individual provider Active NPI Internal Medicine Physician · Walla Walla, WA
NPI 1174513873 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1174513873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD25826 (OR)
- Practice address
- 55 W Tietan St
Walla Walla, WA 99362-4445 - Phone
- (509) 525-3720
- Fax
- (509) 522-1593
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD25826 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Washington, PLLC | Past |
Accepting new patients | |
| Privia Medical Group Washington, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD25826 | OR | Yes |
Addresses
Primary practice location
55 W Tietan St
Walla Walla, WA 99362-4445
Mailing address
55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 525-3720
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278110 | Medicaid | OR | |
| 1174513873 | Other | OR | NPI |
Other providers in Walla Walla, WA
- Alisha Andersen
- Alessa Anderson
- Amanda Anderson
- Amy Elizabeth Anderson
- Andrew S Edwards MD PC
- Jimmye Dell Angell-Erickson
- Antonio D. Caso, D.D.S., P.S.
- Snejana Apley
- Rainee Ann Arevalo
- Arias Physical Therapy Inc
All providers in Walla Walla, WA · Internal Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. 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.