Individual
AMANDA ROSE HIESTAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4803 84TH ST SW, MUKILTEO, WA 98275-3023
(425) 290-6024
(425) 290-8016
Mailing address
4803 84TH ST SW, MUKILTEO, WA 98275-3023
(425) 290-6024
(425) 290-8016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60152458
WA
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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