| Doctor Name: | AMANDA JANE HOLEN |
| NPI Number: | 1033575113 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP60620377 |
| Business Practice Address: | 202 State Avenue North Kent, WA - 98031 |
| Business Phone Number: | 2533727866 |
| Business Fax Number: | |
| Mailing Address: | 202 State Avenue North, KENT |
| State: | WA |
| Postal Code: | 98030 |
| Phone Number: | 2533727866 |
| Fax Number: | |
| NPI Enumeration Date: | 01/05/2016 |
| NPI Last Update Date: | 02/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | AP60620377 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |