# LUMINOSITY MEDICAL ALLAINCE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134893191
- **Authorized official:** MRS. AMANDA SUE MACKLIN ARNP (FOUNDER)
- **Authorized official phone:** (360) 362-0146

## Contact information

- **Practice address:** 426 SW HAYWORTH DR UNIT C203, PORT ORCHARD, WA 98367-5015
- **Practice address phone:** (360) 362-0146
- **Mailing address:** 426 SW HAYWORTH DR UNIT C203, PORT ORCHARD, WA 98367-5015
- **Mailing address phone:** (419) 860-3644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2021
- **Last updated:** 08/04/2021