Provider Demographics
NPI:1386273217
Name:WRIGHT, ANDREA MORROW
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MORROW
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 YAUGER WAY SW UNIT L203
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8348
Mailing Address - Country:US
Mailing Address - Phone:712-209-4958
Mailing Address - Fax:
Practice Address - Street 1:9329 MARTIN WAY E STE M
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-5738
Practice Address - Country:US
Practice Address - Phone:712-209-4958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61061360363LP0808X
MO2020008424363LP0808X
WAAP61061360363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61061360OtherBOARD OF NURSING
MO2020008424OtherBOARD CERTIFICATION