Provider Demographics
NPI:1033393590
Name:STOREY, AMY J (LMP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:STOREY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 AUBURN WAY N
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-1312
Mailing Address - Country:US
Mailing Address - Phone:253-850-2225
Mailing Address - Fax:253-850-5757
Practice Address - Street 1:4701 AUBURN WAY N
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-1312
Practice Address - Country:US
Practice Address - Phone:253-850-2225
Practice Address - Fax:253-850-5757
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor