Individual
AMANDA AYUMI IBARAKI STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4219 SW JUNEAU ST, SEATTLE, WA 98136-1621
(206) 207-5395
Mailing address
4432 48TH AVE SW, SEATTLE, WA 98116-4018
(650) 207-8232
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
IMF76440
CA
106H00000X
Marriage & Family Therapist
Primary
MG60882994
WA
Other
Enumeration date
09/19/2012
Last updated
09/25/2019
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