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Individual

AMANDA STARTUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2120 INDEPENDENCE RD, OUTLOOK, WA 98938-9570
(206) 465-6807
Mailing address
2120 INDEPENDENCE RD, OUTLOOK, WA 98938-9570

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60442329
WA
390200000X
Student in an Organized Health Care Education/Training Program
201140769RN
OR

Other

Enumeration date
01/04/2012
Last updated
01/15/2014
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