Provider Demographics
NPI:1588735377
Name:BARBER, ANDREW LEE (OD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEE
Last Name:BARBER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 OLD FAIRHAVEN PKWY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7411
Mailing Address - Country:US
Mailing Address - Phone:360-733-1190
Mailing Address - Fax:360-734-1306
Practice Address - Street 1:1207 OLD FAIRHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7411
Practice Address - Country:US
Practice Address - Phone:360-733-1190
Practice Address - Fax:360-734-1306
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003828152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8880684Medicare PIN