Individual
AMANDA VANDER WOUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
318 2ND ST S, NAMPA, ID 83651-3765
(208) 467-3006
Mailing address
318 2ND ST S, NAMPA, ID 83651-3765
(208) 467-3006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-2410
AL
363A00000X
Physician Assistant
Primary
PA-2673
ID
Other
Enumeration date
06/30/2022
Last updated
03/19/2025
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