Provider Demographics
NPI:1851880702
Name:WENDT, AMELIA CURLEY (MD)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:CURLEY
Last Name:WENDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:CURLEY
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12030 NE 130TH LN
Mailing Address - Street 2:STE 300
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-899-3602
Mailing Address - Fax:425-899-1135
Practice Address - Street 1:12030 NE 130TH LN
Practice Address - Street 2:STE 300
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-899-3602
Practice Address - Fax:425-899-1135
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD610708242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1851880702Medicaid