Healthcare Provider Details

I. General information

NPI: 1073941266
Provider Name (Legal Business Name): AMANDA HAPENNY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 NW 36TH ST STE 210
SEATTLE WA
98107-4959
US

IV. Provider business mailing address

1763B NW 58TH ST
SEATTLE WA
98107-3042
US

V. Phone/Fax

Practice location:
  • Phone: 508-728-7672
  • Fax:
Mailing address:
  • Phone: 508-728-7672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number068746-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: