Provider Demographics
NPI:1598885055
Name:TRAUT, AMANDA RUTH (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:RUTH
Last Name:TRAUT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:MANDY
Other - Middle Name:RUTH
Other - Last Name:TRAUT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:10400 NE 2ND ST
Mailing Address - Street 2:106
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2321
Mailing Address - Country:US
Mailing Address - Phone:206-914-1280
Mailing Address - Fax:
Practice Address - Street 1:8266 LAKE CITY WAY NE STE C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4475
Practice Address - Country:US
Practice Address - Phone:206-914-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60157023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health