Provider Demographics
NPI:1104261874
Name:COVINGTON, ANDREW PHILIP (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PHILIP
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16259 SYLVESTER RD SW STE 404
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3059
Mailing Address - Country:US
Mailing Address - Phone:206-243-3049
Mailing Address - Fax:206-965-4199
Practice Address - Street 1:16259 SYLVESTER RD SW STE 404
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3059
Practice Address - Country:US
Practice Address - Phone:206-243-3049
Practice Address - Fax:206-965-4199
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60788009208100000X
UT5499181-1205208100000X
AZR73802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2088786Medicaid