Andrea Boothby, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15-04-04 Issued in OR

Practice address

340 NW 5TH St Ste 202
Redmond, OR 97756-1869

Phone

(541) 504-2218

Fax

(541) 504-1195

NPI assigned

Sep 23, 2015

Last updated

Sep 23, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1760851455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560516",
            "telephone_number": "541-504-2218",
            "fax_number": "541-504-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW 5TH ST STE 202",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561869",
            "telephone_number": "541-504-2218",
            "fax_number": "541-504-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHBY",
        "first_name": "ANDREA",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-04-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodywise Chiropractic PC
• Zoe Boger
• Alexis Bondhus
• Thomas Stewart Bonn, PT
• Hannah Boomer, CNM
• Olivia Boots, CRNA
• Don R. Borjesson, LCSW
• Lindsey Bosse
• Michelle Elizabeth Boulanger, QMHP
• Michael R Bouska, M.D., M.P.H

• Addiction (Substance Use Disorder) Counselor in Redmond, OR
• Providers in Redmond, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.