Individual provider Active NPI

Cecelia Andress, LMP

  • Specialist
  • Mount Vernon, WA
National Provider Identifier
1871774208
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00023152 Issued in WA
Practice address
2114 Riverside Dr Ste 103
Mount Vernon, WA 98273-5453
Phone
(360) 848-1934
NPI assigned
Nov 14, 2007
Last updated
Nov 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00023152 WA Primary

Addresses

Primary practice location

2114 Riverside Dr Ste 103
Mount Vernon, WA 98273-5453

Mailing address

2114 Riverside Dr Ste 103
Mount Vernon, WA 98273-5453
Phone (360) 848-1934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00023152WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1871774208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 RIVERSIDE DR STE 103",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735453",
            "telephone_number": "360-848-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 RIVERSIDE DR STE 103",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735453",
            "telephone_number": "360-848-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRESS",
        "first_name": "CECELIA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00023152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.