Provider Demographics
NPI:1891351888
Name:FLINT, AMANDA OLNEY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:OLNEY
Last Name:FLINT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:OLNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1535 MADRONA POINT DR APT B
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2326
Mailing Address - Country:US
Mailing Address - Phone:360-649-3877
Mailing Address - Fax:
Practice Address - Street 1:5050 WA-303
Practice Address - Street 2:A101
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311
Practice Address - Country:US
Practice Address - Phone:360-627-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60941113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist