Active NPI
Andrea Jeanne Goldman, ANDREA GOLDMAN L.M.P
- Mechanotherapist
- Bainbridge Island, WA
National Provider Identifier
1972721116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA00014174
- Practice address
- 164 Knechtel Way NE
Bainbridge Island, WA 98110-2838 - Phone
- (206) 371-7909
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA00014174 | WA | Primary |
Addresses
Primary practice location
164 Knechtel Way NE
Bainbridge Island, WA 98110-2838
Mailing address
PO Box 465
Indianola, WA 98342-0465
Phone (206) 371-7909
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00014174 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972721116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 465",
"city": "INDIANOLA",
"state": "WA",
"postal_code": "983420465",
"telephone_number": "206-371-7909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 KNECHTEL WAY NE",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981102838",
"telephone_number": "206-371-7909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "ANDREA",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "ANDREA GOLDMAN L.M.P",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA00014174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.