Provider Demographics
NPI:1104449594
Name:NODDINGS, AMANDA K (NAC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:K
Last Name:NODDINGS
Suffix:
Gender:F
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E PIPER GLEN CT
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9202
Mailing Address - Country:US
Mailing Address - Phone:509-218-6064
Mailing Address - Fax:
Practice Address - Street 1:6025 N ASSEMBLY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-7674
Practice Address - Country:US
Practice Address - Phone:509-326-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60206882376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANC60206882OtherWA STATE DEPARTMENT OF HEALTH