Provider Demographics
NPI:1043977424
Name:STRATTON, AMANDA NICOLE (MD (MEDICAL STUDENT))
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MD (MEDICAL STUDENT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 SW CURRY ST APT 8
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2994
Mailing Address - Country:US
Mailing Address - Phone:360-561-5002
Mailing Address - Fax:
Practice Address - Street 1:1011 SW CURRY ST APT 8
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2994
Practice Address - Country:US
Practice Address - Phone:360-561-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program