Provider Demographics
NPI:1609220235
Name:LIVINGSTON, AMBER (DNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34738
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1738
Mailing Address - Country:US
Mailing Address - Phone:425-899-1600
Mailing Address - Fax:425-899-1659
Practice Address - Street 1:12333 NE 130TH LN STE TAN 320
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-899-0555
Practice Address - Fax:425-899-9458
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60232815390200000X
OR201141451RN390200000X
WAAP60865817363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program