Provider Demographics
NPI:1760856991
Name:WENDT, AMANDA JOELLE (MA)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:JOELLE
Last Name:WENDT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3213
Mailing Address - Country:US
Mailing Address - Phone:253-218-8019
Mailing Address - Fax:
Practice Address - Street 1:1000 AUBURN WAY S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6132
Practice Address - Country:US
Practice Address - Phone:253-218-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health