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Individual

AMANDA MCDONOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4755 S 48TH ST, TACOMA, WA 98409-1919
(253) 475-4611
Mailing address
4755 S 48TH ST, TACOMA, WA 98409-1919

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2143995
TX
225200000X
Physical Therapy Assistant
53759
CA
225200000X
Physical Therapy Assistant
9694
OR
225200000X
Physical Therapy Assistant
CP033316A
WA
225200000X
Physical Therapy Assistant
Primary
PTP-PTA-LIC-15182
MT

Other

Enumeration date
11/29/2018
Last updated
02/19/2025
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