Stickney, Andre L

Stickney, Andre L is an individual health care provider with primary practice located at 1601 E 4Th Plain Blvd Bldg 17 Ste B222, Vancouver WA 98661-3753. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Stickney, Andre L can be contacted via phone (390) 397-8484.

Contact Information

Primary practice address
1601 E 4Th Plain Blvd Bldg 17 Ste B222 Vancouver WA 98661-3753
Phone: (390) 397-8484
Fax: (360) 397-8494
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 103K00000X Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CG60410111 Washington

Profile Details

NPI number 1518224369
LBN Legal business name Stickney, Andre L
Credentials AAC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2012
Last updated May 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518224369 NPPES
Oregon MEDICAID 164936
Oregon Other R0000WDBCH

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