Provider Demographics
NPI:1477010700
Name:VIOLETTE, AMANDA MICHELLE
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MICHELLE
Last Name:VIOLETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 ROCK ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5828
Mailing Address - Country:US
Mailing Address - Phone:828-776-1781
Mailing Address - Fax:
Practice Address - Street 1:3340 ROCK ISLAND RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5828
Practice Address - Country:US
Practice Address - Phone:828-776-1781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60912956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist