Provider Demographics
NPI:1164956942
Name:MEYERS, AMANDA (MS, CN, LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MS, CN, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 8TH ST STE 260
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3399
Mailing Address - Country:US
Mailing Address - Phone:360-524-6127
Mailing Address - Fax:360-282-0723
Practice Address - Street 1:101 E 8TH ST STE 260
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3399
Practice Address - Country:US
Practice Address - Phone:360-524-6127
Practice Address - Fax:360-282-0723
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU60784799133N00000X
WALH61033476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist