Individual
AMANDA JO GLOUDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
2815 E 19TH ST APT S, VANCOUVER, WA 98661-4636
(360) 910-5617
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
CG61340298
WA
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/29/2022
Last updated
05/02/2023
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