Provider Demographics
NPI:1972612794
Name:WOOD, AMANDA ERNST (PHD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ERNST
Last Name:WOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VA PUGET SOUND HEALTH CARE SYSTEM
Mailing Address - Street 2:AMERICAN LAKE DIV. (A-116-R)
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-0001
Mailing Address - Country:US
Mailing Address - Phone:253-583-1652
Mailing Address - Fax:
Practice Address - Street 1:VA PUGET SOUND HEALTH CARE SYSTEM
Practice Address - Street 2:AMERICAN LAKE DIV. (A-116-R)
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0001
Practice Address - Country:US
Practice Address - Phone:253-583-1652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002373103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical