Individual
MRS. AMANDA SUE MACKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
630 N FAIRVIEW DR # 256, TACOMA, WA 98406-1015
(253) 777-1423
Mailing address
426 SW HAYWORTH DR UNIT 203, PORT ORCHARD, WA 98367-5015
(253) 313-2284
(253) 276-6907
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60784445
WA
363LA2200X
Adult Health Nurse Practitioner
N360791741
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP60784445
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2087977
—
WA
Enumeration date
08/28/2017
Last updated
03/29/2025
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