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Individual

MRS. AMANDA JOAN AMICUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPC

Contact information

Practice address
221 WELLS AVE S, SUITE 100, RENTON, WA 98057-2161
(425) 528-2008
Mailing address
2310 165TH AVENUE CT E, LAKE TAPPS, WA 98391-4928
(206) 643-0283

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
WA

Other

Enumeration date
10/28/2014
Last updated
10/28/2014
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