MEDICARE: AMANDA MATTHEWS ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP60896768	WA

General Provider Information

NPI Number	:	1639651086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MATTHEWS ARNP

Provider Business Mailing Address
First Line	:	6023 205TH AVE E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8602
Country	:	US
Telephone Number	:	253-961-1528
Fax Number	:

Provider Business Practice Location Address
First Line	:	6023 205TH AVE E
Second Line	:
City	:	BONNEY LAKE
State	:	WA
Zip	:	98391-8602
Country	:	US
Telephone Number	:	253-961-1528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2018
Last Update Date	:	01/16/2026

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