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Individual

AMANDA NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
5420 BARNES AVE NW, SEATTLE, WA 98107-3839
(206) 789-7975
(206) 782-6177
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60628646
WA
225100000X
Physical Therapist
6564
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528355765
WA
Enumeration date
07/08/2011
Last updated
04/05/2016
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