Provider Demographics
NPI:1063750776
Name:ENGSTROM, ANDREW PAUL DANIEL (MS)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:PAUL DANIEL
Last Name:ENGSTROM
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 N 100TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9426
Mailing Address - Country:US
Mailing Address - Phone:360-739-7996
Mailing Address - Fax:
Practice Address - Street 1:10116 NE 183RD ST
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3416
Practice Address - Country:US
Practice Address - Phone:360-379-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist