Provider Demographics
NPI:1194353516
Name:CROOKS, ANDREA JAMIE (DO)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JAMIE
Last Name:CROOKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JAMIE
Other - Last Name:CROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:404 YAUGER WAY SW STE 100
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8152
Mailing Address - Country:US
Mailing Address - Phone:564-669-5150
Mailing Address - Fax:564-669-5155
Practice Address - Street 1:404 YAUGER WAY SW STE 100
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8152
Practice Address - Country:US
Practice Address - Phone:564-669-5150
Practice Address - Fax:564-669-5155
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A19331207Q00000X
WAOP61425067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine