Provider Demographics
NPI:1861222531
Name:DOBBINS, AMBER A
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:A
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 COOPER POINT RD SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-7204
Mailing Address - Country:US
Mailing Address - Phone:360-464-9052
Mailing Address - Fax:
Practice Address - Street 1:308 WEST OAK ST
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:WA
Practice Address - Zip Code:98568
Practice Address - Country:US
Practice Address - Phone:360-388-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician