Provider Demographics
NPI:1104496132
Name:DZIKOWSKI, ANDREW (ND, LAC, ARNP, LMT)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:DZIKOWSKI
Suffix:
Gender:M
Credentials:ND, LAC, ARNP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 130TH ST SW APT H102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7383
Mailing Address - Country:US
Mailing Address - Phone:425-224-7188
Mailing Address - Fax:949-250-6911
Practice Address - Street 1:5005 200TH ST SW STE 102
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6679
Practice Address - Country:US
Practice Address - Phone:201-600-6817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60621233163W00000X, 163WA0400X
WAAC61209772171100000X
WAMA60792173225700000X
WAAP61571216363LP0808X
WANT61195829175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health