Provider Demographics
NPI:1598181711
Name:MORGAN, AMANDA DREW (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:DREW
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:11303 NE 207TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-3101
Mailing Address - Country:US
Mailing Address - Phone:503-984-4307
Mailing Address - Fax:
Practice Address - Street 1:11303 NE 207TH AVE
Practice Address - Street 2:
Practice Address - City:BRUSH PRAIRIE
Practice Address - State:WA
Practice Address - Zip Code:98606-3101
Practice Address - Country:US
Practice Address - Phone:503-984-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor