Provider Demographics
NPI:1154771632
Name:SCOTT, ANDREA L (RN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20128 SE 258TH PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6178
Mailing Address - Country:US
Mailing Address - Phone:206-579-8872
Mailing Address - Fax:
Practice Address - Street 1:20128 SE 258TH PL
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-6178
Practice Address - Country:US
Practice Address - Phone:206-579-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00140731163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse