MEDICARE: AMANDA LYNNE STETZ LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA61659482	WA

General Provider Information

NPI Number	:	1225832942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LYNNE STETZ LMT

Provider Business Mailing Address
First Line	:	31722 WINSTON ST SE
Second Line	:
City	:	SULTAN
State	:	WA
Zip	:	98294-4019
Country	:	US
Telephone Number	:	425-223-7695
Fax Number	:

Provider Business Practice Location Address
First Line	:	31722 WINSTON ST SE
Second Line	:
City	:	SULTAN
State	:	WA
Zip	:	98294-4019
Country	:	US
Telephone Number	:	425-223-7695
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	04/02/2025

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