Basic Information
| Provider Information | |||||||||
| NPI: | 1891711446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDONE | ||||||||
| FirstName: | ANDREEA | ||||||||
| MiddleName: | LUIZA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 875 OAK ST SE STE 5070 | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973013998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035618565 | ||||||||
| FaxNumber: | 5035618560 | ||||||||
| Practice Location | |||||||||
| Address1: | 875 OAK ST SE STE 5070 | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973013998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035618565 | ||||||||
| FaxNumber: | 5035618560 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 06/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | MD26553 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | MD26553 | 01 | OR | LICENSE | OTHER |