Healthcare Provider Details

I. General information

NPI: 1770310591
Provider Name (Legal Business Name): AMANDA K BARNETT PCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA K CHARLTON

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8285 SW NIMBUS AVE STE 148
BEAVERTON OR
97008-6465
US

IV. Provider business mailing address

8285 SW NIMBUS AVE STE 148
BEAVERTON OR
97008-6465
US

V. Phone/Fax

Practice location:
  • Phone: 503-352-3260
  • Fax:
Mailing address:
  • Phone: 971-202-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR9755
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: