Provider Demographics
NPI:1487999561
Name:VOORHEES, AMANDA NOEL (MOTR/L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NOEL
Last Name:VOORHEES
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:NOEL
Other - Last Name:FAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:801 TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-9387
Mailing Address - Country:US
Mailing Address - Phone:360-855-3873
Mailing Address - Fax:
Practice Address - Street 1:801 TRAIL RD
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-9387
Practice Address - Country:US
Practice Address - Phone:360-855-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 60144211174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist