Provider Demographics
NPI:1528681350
Name:VLAHOVICH, ANDREW N
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:N
Last Name:VLAHOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13936 103RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-5220
Mailing Address - Country:US
Mailing Address - Phone:949-278-1141
Mailing Address - Fax:
Practice Address - Street 1:4014 52ND ST NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-1980
Practice Address - Country:US
Practice Address - Phone:949-278-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician