Individual
AMANDA BUCKHALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
(360) 423-2311
Mailing address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
(360) 423-2311
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00052833
WA
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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