Healthcare Provider Details

I. General information

NPI: 1457920217
Provider Name (Legal Business Name): AMANDA BARCHUK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SENANAYAKE PA-C

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CHAPEL HILLS DR STE 325
COLORADO SPRINGS CO
80920-1061
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-4120
  • Fax: 719-364-4121
Mailing address:
  • Phone: 970-624-4123
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007858
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: