Provider Demographics
NPI:1851744569
Name:YORK, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98850-9522
Mailing Address - Country:US
Mailing Address - Phone:509-679-9935
Mailing Address - Fax:
Practice Address - Street 1:908 10TH AVE SW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-1376
Practice Address - Country:US
Practice Address - Phone:509-787-3531
Practice Address - Fax:509-787-2016
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist