Doctor Name: | AMANDA WASHINGTON |
NPI Number: | 1093176471 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | |
Business Practice Address: | 725 S Wahanna Rd Providence North Coast Clinic Seaside, OR - 97138 |
Business Phone Number: | 5037177000 |
Business Fax Number: | |
Mailing Address: | 18831 Ne 279th St, BATTLE GROUND |
State: | WA |
Postal Code: | 986049717 |
Phone Number: | 3609217843 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2016 |
NPI Last Update Date: | 03/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |