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General NPI Number Information
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NPI Number | 1174341812
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Entity Type | Individual
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Provider Name | AMBER DARLENE HOSTETTER LMT, CCT
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 7500 212TH ST SW ROOM 1, SUITE 107
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City | EDMONDS
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State | WA
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Zip | 98026-7641
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Country | US
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Telephone | 206-779-6054
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Fax |
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Provider Business Mailing Address
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Address Line | 9325 244TH ST SW APT V203
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City | EDMONDS
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State | WA
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Zip | 98020-6590
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Country | US
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Telephone | 206-779-6054
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60592239
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License Number State | WA
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