Individual
AMANDA HUDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7000
(253) 985-2853
Mailing address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7000
(253) 985-2853
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60702234
WA
363LP2300X
Primary Care Nurse Practitioner
AP60702234
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104508
—
WA
Enumeration date
10/04/2016
Last updated
12/04/2020
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