Individual
AMY E ANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
751 NE BLAKELY DR, SUITE 3020, ISSAQUAH, WA 98029-6201
(425) 313-4704
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
PA1004683
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0292563
LABOR AND INDUSTRY
WA
01
—
MDA0533
AK DSHS
WA
01
—
P01011913
MEDICARE RAILROAD
WA
Enumeration date
07/23/2006
Last updated
04/05/2021
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