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1710361225
AMANDA WIDMAN
VANCOUVER, WA
NPI
1710361225
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: 2000021970)
Enumeration Date
2015-07-14
Last Update Date
2015-07-14
Business Address
-- AMANDA WIDMAN ATC
6700 NE 162ND AVE STE 411
VANCOUVER, WA 98682-3863
Phone number: 509-703-8880
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Mailing Address
-- AMANDA WIDMAN ATC
PO BOX 236
BAKER CITY, OR 97814-0236
Phone number: 509-703-8880
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