Provider Demographics
NPI:1992514392
Name:HAMILTON, AMBER AUTUMN
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:AUTUMN
Last Name:HAMILTON
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 1:17020 E FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-9205
Mailing Address - Country:US
Mailing Address - Phone:509-710-1670
Mailing Address - Fax:
Practice Address - Street 1:17020 E FREDERICK RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-9205
Practice Address - Country:US
Practice Address - Phone:509-710-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605651912125J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125J00000XDental ProvidersDental Therapist