Individual
AMANDA MIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740-2312
(304) 487-7000
Mailing address
4801 RAINIER AVE S APT 210, SEATTLE, WA 98118-2181
(720) 982-5219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13179427-1204
UT
207R00000X
Internal Medicine Physician
Primary
DR.0064756
CO
208M00000X
Hospitalist Physician
CDRH.0064756
CO
Other
Enumeration date
07/08/2016
Last updated
07/29/2024
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