MEDICARE: AMANDA NELSON

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	1041C0700X	Clinical Social Worker	SC61189914	WA

General Provider Information

NPI Number	:	1457205734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA NELSON

Provider Business Mailing Address
First Line	:	15404 218TH ST SE
Second Line	:
City	:	MONROE
State	:	WA
Zip	:	98272-9162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6210 75TH ST W STE 100
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-8303
Country	:	US
Telephone Number	:	425-328-9745
Fax Number	:

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

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	03/02/2026

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Directions to “ AMANDA NELSON ” Practice Location

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