Healthcare Provider Details

I. General information

NPI: 1376328013
Provider Name (Legal Business Name): AMI WOO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33507 9TH AVE S STE A
FEDERAL WAY WA
98003-6397
US

IV. Provider business mailing address

33507 9TH AVE S STE A
FEDERAL WAY WA
98003-6397
US

V. Phone/Fax

Practice location:
  • Phone: 253-874-5404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61568820
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number60570842
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: