Individual
AMY FENLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1728 W MARINE VIEW DR, EVERETT, WA 98201-2094
(425) 339-5453
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW00004427
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017375
—
WA
Enumeration date
11/10/2006
Last updated
12/11/2012
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