Individual
AMANDA MASEK DOETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
777 29TH ST STE 301, BOULDER, CO 80303-2316
(303) 440-8243
(303) 440-0292
Mailing address
777 29TH ST STE 301, BOULDER, CO 80303-2316
(303) 440-8243
(303) 440-0292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2164
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77656369
—
CO
01
—
P00728529
RAILROAD MEDICARE PIN
CO
Enumeration date
01/27/2006
Last updated
08/25/2023
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