Provider Demographics
NPI:1104295153
Name:FAUCETT, AMARA (LMT)
Entity type:Individual
Prefix:
First Name:AMARA
Middle Name:
Last Name:FAUCETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 W INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4722
Mailing Address - Country:US
Mailing Address - Phone:509-327-8188
Mailing Address - Fax:509-327-8182
Practice Address - Street 1:524 W INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4722
Practice Address - Country:US
Practice Address - Phone:509-327-8188
Practice Address - Fax:509-327-8182
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60578800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist