Provider Demographics
NPI:1164840047
Name:PRESTON, AMBER ROSE (DC, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:ROSE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:DC, LAT, ATC
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:MORISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3963 SAND DOLLAR RD W
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-5610
Mailing Address - Country:US
Mailing Address - Phone:208-874-9581
Mailing Address - Fax:
Practice Address - Street 1:9040A JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60764626111N00000X
20000355042255A2300X
WAA1614583902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No111N00000XChiropractic ProvidersChiropractor