Individual
MICHAEL ANTHONY ST AMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA213270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2222166
—
WA
05
—
500811653
—
OR
Enumeration date
05/17/2018
Last updated
11/12/2025
Update your record
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