Provider Demographics
NPI:1033687710
Name:BIONDO, AMY (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BIONDO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 MCGRAW ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2241
Mailing Address - Country:US
Mailing Address - Phone:718-669-2054
Mailing Address - Fax:
Practice Address - Street 1:531 BROADWAY E STE 10
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5023
Practice Address - Country:US
Practice Address - Phone:503-684-8252
Practice Address - Fax:866-859-8195
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-11
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009076101YM0800X
WA61302594163W00000X
WAAP61332817363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty