Healthcare Provider Details

I. General information

NPI: 1538410709
Provider Name (Legal Business Name): AMANDA LEIGH CHRISTIAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 07/31/2021
Certification Date: 07/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE
SEATTLE WA
98104-3005
US

IV. Provider business mailing address

825 EASTLAKE AVE
SEATTLE WA
98104
US

V. Phone/Fax

Practice location:
  • Phone: 206-334-8756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number60253194
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number00173401
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: