Provider Demographics
NPI:1417299025
Name:PRIES, AMBER L (ARNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:PRIES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:L
Other - Last Name:PATTISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 DIVISION AVE # 201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1646
Mailing Address - Country:US
Mailing Address - Phone:253-403-9200
Mailing Address - Fax:
Practice Address - Street 1:1105 DIVISION AVE # 201
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1646
Practice Address - Country:US
Practice Address - Phone:253-403-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60327806363L00000X, 363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology