MEDICARE: AMANDA ELYSE CHANDLER RD, CD, ACSM-CEP

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	133V00000X	Registered Dietitian	86092048
2	224Y00000X	Clinical Exercise Physiologist

General Provider Information

NPI Number	:	1477392918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ELYSE CHANDLER RD, CD, ACSM-CEP

Provider Business Mailing Address
First Line	:	1108 E BRIDGEPORT AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99207-2811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9827 N NEVADA ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-3407
Country	:	US
Telephone Number	:	509-468-7000
Fax Number	:

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

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	03/07/2026

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