Healthcare Provider Details

I. General information

NPI: 1972018042
Provider Name (Legal Business Name): AMY MOK PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7803 NE FOURTH PLAIN BLVD
VANCOUVER WA
98662-7294
US

IV. Provider business mailing address

359 NW 47TH ST
SEATTLE WA
98107-4446
US

V. Phone/Fax

Practice location:
  • Phone: 586-480-7000
  • Fax: 360-695-0628
Mailing address:
  • Phone: 586-480-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60784269
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAP60784269
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: