Provider Demographics
NPI:1821393679
Name:FRANKLIN, AMANDA CLAIRE (MED)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CLAIRE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROANOKE PARK COUNSELING
Mailing Address - Street 2:2601 BROADWAY EAST
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102
Mailing Address - Country:US
Mailing Address - Phone:206-854-6436
Mailing Address - Fax:
Practice Address - Street 1:ROANOKE PARK COUNSELING
Practice Address - Street 2:2601 BROADWAY EAST
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109
Practice Address - Country:US
Practice Address - Phone:206-323-7131
Practice Address - Fax:206-322-4078
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
WA00004551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist