| Doctor Name: | AMY ANDERSON |
| NPI Number: | 1275642936 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA, LMP |
| License Number: | RC00049330 |
| Business Practice Address: | 12506 18th St Ne Lake Stevens, WA - 98258 |
| Business Phone Number: | 4253342154 |
| Business Fax Number: | 4253771880 |
| Mailing Address: | 11910 28th Pl Ne, LAKE STEVENS |
| State: | WA |
| Postal Code: | 982589158 |
| Phone Number: | 4252104019 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 10/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | RC00049330 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |