Provider Demographics
NPI:1215734579
Name:WARD, DEANDREA (CPC)
Entity type:Individual
Prefix:
First Name:DEANDREA
Middle Name:
Last Name:WARD
Suffix:
Gender:
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10711 NE 86TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3139
Mailing Address - Country:US
Mailing Address - Phone:360-903-1427
Mailing Address - Fax:
Practice Address - Street 1:6221 NE FOURTH PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7206
Practice Address - Country:US
Practice Address - Phone:360-903-1427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist