Healthcare Provider Details

I. General information

NPI: 1255242855
Provider Name (Legal Business Name): AMANDA NORMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 HARVARD AVE E
SEATTLE WA
98102-3913
US

IV. Provider business mailing address

8519 5TH AVE NE APT A
SEATTLE WA
98115-2967
US

V. Phone/Fax

Practice location:
  • Phone: 206-549-0262
  • Fax:
Mailing address:
  • Phone: 206-549-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA.61287377
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: