Individual
AMANDA R FLYCKT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
413 LILLY RD NE, PMG SW WA PSPH HOSPITALISTS, OLYMPIA, WA 98506-5133
(360) 493-4069
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60520308
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041629
—
WA
Enumeration date
12/12/2011
Last updated
05/23/2022
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