Provider Demographics
NPI:1174416945
Name:SELLARS, AMBER (LMT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SELLARS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20711 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98166-4223
Mailing Address - Country:US
Mailing Address - Phone:253-266-9242
Mailing Address - Fax:
Practice Address - Street 1:17090 AVONDALE WAY NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4409
Practice Address - Country:US
Practice Address - Phone:425-780-7208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61619946225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist