Provider Demographics
NPI:1194983551
Name:METHVIN, AMANDA BROOKE (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BROOKE
Last Name:METHVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PACIFIC MEDICAL CENTERS AT BEACON HILL
Mailing Address - Street 2:1200 12TH AVE S
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2712
Mailing Address - Country:US
Mailing Address - Phone:206-326-2400
Mailing Address - Fax:206-621-4434
Practice Address - Street 1:1200 12TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144
Practice Address - Country:US
Practice Address - Phone:206-326-2400
Practice Address - Fax:206-621-4434
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065707207R00000X
WAMD60403542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine