| Doctor Name: | MARK ANDREWS |
| NPI Number: | 1316358534 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BA CADC-1 |
| License Number: | 08-06-04 |
| Business Practice Address: | 94235 Moore St Gold Beach, OR - 974449699 |
| Business Phone Number: | 5412474082 |
| Business Fax Number: | 5412474082 |
| Mailing Address: | 29821 Colvin St., GOLD BEACH |
| State: | OR |
| Postal Code: | 97444 |
| Phone Number: | 5412474082 |
| Fax Number: | 5412474082 |
| NPI Enumeration Date: | 05/09/2014 |
| NPI Last Update Date: | 05/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 08-06-04 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |