Healthcare Provider Details

I. General information

NPI: 1821669169
Provider Name (Legal Business Name): AMBER LAMPERS SUDP-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 TACOMA AVE S
TACOMA WA
98402-1903
US

IV. Provider business mailing address

1305 TACOMA AVE S
TACOMA WA
98402-1903
US

V. Phone/Fax

Practice location:
  • Phone: 253-396-5800
  • Fax:
Mailing address:
  • Phone: 253-396-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO61182798
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: