Provider Demographics
NPI:1114319928
Name:DAHNKE, AMBER N (PAC)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:N
Last Name:DAHNKE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:N
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11511 CANTERWOOD BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-5817
Mailing Address - Country:US
Mailing Address - Phone:253-530-2940
Mailing Address - Fax:253-530-2970
Practice Address - Street 1:11511 CANTERWOOD BLVD STE 140
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5817
Practice Address - Country:US
Practice Address - Phone:253-530-2940
Practice Address - Fax:253-530-2970
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60702539363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2068721Medicaid
WA2068721Medicaid