Individual
AMANDA BREITENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3231 WILLAMETTE DR NE STE C, LACEY, WA 98516-1378
(844) 452-1758
Mailing address
1716 ELIZABETH ST SE, OLYMPIA, WA 98501-2711
(248) 249-4787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
61213054
WA
235Z00000X
Speech-Language Pathologist
Primary
SI61076397
WA
Other
Enumeration date
08/25/2020
Last updated
07/09/2025
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