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General NPI Number Information
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NPI Number | 1003522947
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Entity Type | Individual
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Provider Name | AMANDA ANDRUS MS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 450 NW GILMAN BLVD STE 201
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City | ISSAQUAH
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State | WA
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Zip | 98027-2722
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Country | US
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Telephone | 425-835-2503
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Fax |
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Provider Business Mailing Address
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Address Line | 1279 MATCHPOINT DR
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City | AMMON
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State | ID
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Zip | 83406-4570
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Country | US
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Telephone | 208-520-0938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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