Individual provider Active NPI

Andrea Jo King, M.D.

  • Surgery Physician
  • Vancouver, WA
National Provider Identifier
1639496052
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60647438 Issued in WA
Practice address
505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965
Phone
(360) 514-1854
Fax
(360) 514-6063
NPI assigned
Apr 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Surgery) Physician 2086H0002X MD60647438 WA
Surgical Critical Care Physician 2086S0102X MD60647438 WA
Surgery Physician 208600000X MD60647438 WA Primary

Addresses

Primary practice location

505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965

Mailing address

11100 Euclid Ave
Cleveland, OH 44106-1716

Other practice location 1

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-3027

Other practice location 2

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 816-5706

Other practice location 3

400 NE Mother Joseph Pl
Vancouver, WA 98664-3200
Phone (360) 514-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908000855 WA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 5395983787 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of New Mexico School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9739092065, 101 clinicians
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone (360) 514-1734

505 NE 87TH Ave
Suite 301
Vancouver, WA 98664-1965
Phone (360) 514-2550

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60647438WAMDHospice and Palliative Medicine (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Surgery CurrentSince Aug 8, 2016 Accepting new patients
Peacehealth CurrentSince Nov 27, 2017 Accepting new patients
The Metrohealth System Current Accepting new patients
Peacehealth CurrentSince May 28, 2025 Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: aking262104@direct.peacehealth.org
  • Direct secure messaging: aking26158@direct.metrohealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1639496052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 87TH AVE STE 301",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641965",
            "telephone_number": "360-514-1854",
            "fax_number": "360-514-6063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-3027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322367",
            "country_code": "US",
            "telephone_number": "360-816-5706",
            "fax_number": "360-696-5038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 NE Mother Joseph Pl",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643200",
            "country_code": "US",
            "telephone_number": "360-514-1778",
            "fax_number": "360-696-5038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "ANDREA",
        "middle_name": "JO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-24",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086H0002X",
            "taxonomy_group": "",
            "desc": "Surgery, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD60647438",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WA",
            "license": "MD60647438",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60647438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.