Individual
AMY BETH WYENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
306 E 16TH ST, SUITE W, VANCOUVER, WA 98663-3411
(360) 931-0376
Mailing address
PO BOX 822467, VANCOUVER, WA 98682-0054
(360) 931-0376
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA00020236
WA
Other
Enumeration date
04/22/2009
Last updated
04/22/2009
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