Andrea K. Street, B.S.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

600 Broadway St
Longview, WA 98632-3256

Phone

(360) 636-4943

NPI assigned

Mar 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Andrea K. Kazeck Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Dietitian, Registered, WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1982959565

  Dietitian, Registered

  NPD

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1679745624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323166",
            "telephone_number": "360-636-6268",
            "fax_number": "360-575-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323256",
            "telephone_number": "360-636-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "ANDREA",
        "middle_name": "K.",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8510075",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1230 7th Ave",
            "city": "Longview",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986323166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "KAZECK",
            "middle_name": "K.",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lillian S. Stoneking, PA-C
• Christina Stops, CPC
• Corey D Strand II, NP
• James Dean Strange, D.C.
• Vincent John Straube
• Sean M Strehlau
• Strengthening Foundations LLC
• Ryan Russell Strilaeff, MD
• Melissa Strom, APRN
• Stuart Orthotics LLC

• Registered Dietitian in Longview, WA
• Providers in Longview, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.