Provider Demographics
NPI:1366229593
Name:LUKEVICH, ANDREA FRANCES QUICK (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:FRANCES QUICK
Last Name:LUKEVICH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:FRANCES QUICK
Other - Last Name:STABILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12046 36TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5637
Mailing Address - Country:US
Mailing Address - Phone:360-303-0122
Mailing Address - Fax:
Practice Address - Street 1:35535 6TH PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-8109
Practice Address - Country:US
Practice Address - Phone:253-874-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61480505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist