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Organization

LUMINOSITY MEDICAL ALLAINCE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMANDA SUE MACKLIN ARNP (FOUNDER)
(360) 362-0146
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
08/03/2021
Last updated
08/04/2021
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