Individual
AMY MARIE VAN GALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SC
Contact information
Practice address
17722 TALBOT RD S, RENTON, WA 98055-5744
(425) 690-3479
(425) 690-9479
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60462983
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2066839
—
WA
Enumeration date
02/28/2007
Last updated
05/21/2020
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