Provider Demographics
NPI:1689145997
Name:FU-KALILIKANE, AMANDA YUENSHUNG (LAC, LMP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:YUENSHUNG
Last Name:FU-KALILIKANE
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:YUENSHUNG
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, LMP
Mailing Address - Street 1:2115 S 56TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2115 S 56TH ST STE 302
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6900
Practice Address - Country:US
Practice Address - Phone:253-627-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-12
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60895286171100000X
WAMA60695887225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist