Provider Demographics
NPI:1982412235
Name:HELWIG, AMANDA CATHERINE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CATHERINE
Last Name:HELWIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W E ST
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:OR
Mailing Address - Zip Code:97048-2708
Mailing Address - Country:US
Mailing Address - Phone:484-843-1760
Mailing Address - Fax:
Practice Address - Street 1:58646 MCNULTY WAY
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-6210
Practice Address - Country:US
Practice Address - Phone:484-843-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24-CRM-2952175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist