Individual
AMANDA DAWN KIDNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12201 PACIFIC AVE S, TACOMA, WA 98444-5126
(253) 536-6425
Mailing address
12201 PACIFIC AVE S, TACOMA, WA 98444-5126
(253) 536-6425
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60747165
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
60747165
—
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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