Provider Demographics
NPI:1992536445
Name:AYOTTE, AMANDA RACHELLE (CPM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RACHELLE
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:RACHELLE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11736 SE 256TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7897
Mailing Address - Country:US
Mailing Address - Phone:360-471-1305
Mailing Address - Fax:
Practice Address - Street 1:11736 SE 256TH PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7897
Practice Address - Country:US
Practice Address - Phone:360-471-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay