Individual
AMY MARIE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ARNP, FNP-C
Contact information
Practice address
615 LILLY RD NE STE 220, PMG SW WA NEUROSURGERY, OLYMPIA, WA 98506-5137
(360) 486-6150
(360) 486-6155
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP60318377
WA
363LF0000X
Family Nurse Practitioner
Primary
AP 60318377
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2024514
—
WA
Enumeration date
01/17/2013
Last updated
01/05/2023
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