Provider Demographics
NPI:1376876151
Name:MORRISON, AMBER MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 SQUALICUM PKWY
Mailing Address - Street 2:ATTN: CREDENTIALS
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1851
Mailing Address - Country:US
Mailing Address - Phone:360-788-6198
Mailing Address - Fax:360-788-6196
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-788-6198
Practice Address - Fax:360-788-6196
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
WAPA60118047363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA255547OtherL&I
WA259167OtherL&I AND CRIME VICTIMS
WA9396554OtherAETNA
WA1376876151Medicaid
WA0031MOOtherREGENCE
WA255547OtherL&I
WA1376876151Medicaid