Provider Demographics
NPI:1124732383
Name:SCHIMKE, AMANDA MICHELLE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MICHELLE
Last Name:SCHIMKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MICHELLE
Other - Last Name:SCHIMKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:232 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5862
Mailing Address - Country:US
Mailing Address - Phone:253-859-0300
Mailing Address - Fax:
Practice Address - Street 1:232 2ND AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5862
Practice Address - Country:US
Practice Address - Phone:253-859-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health