Individual
MS. AMANDA REED PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 E D ST, DEER PARK, WA 99006-5167
(509) 276-5005
(509) 276-7785
Mailing address
901 MOUNTAIN VIEW DR, SHELTON, WA 98584-4401
(509) 496-0130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F10211086
WA
363L00000X
Nurse Practitioner
Primary
AP61250114
WA
Other
Enumeration date
01/10/2022
Last updated
06/15/2023
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