Provider Demographics
NPI:1285956912
Name:PLUMMER, AMANDA ELISABETH (LMP)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:ELISABETH
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 HILLSPRING RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8895
Mailing Address - Country:US
Mailing Address - Phone:360-223-6322
Mailing Address - Fax:
Practice Address - Street 1:301 E RIO VISTA AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-2224
Practice Address - Country:US
Practice Address - Phone:360-223-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60130132174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist