Provider Demographics
NPI:1134420581
Name:TINKLE, AMANDA M (DMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:M
Last Name:TINKLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E 39TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2229
Mailing Address - Country:US
Mailing Address - Phone:360-694-7931
Mailing Address - Fax:360-694-0722
Practice Address - Street 1:117 E 39TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2229
Practice Address - Country:US
Practice Address - Phone:360-694-7931
Practice Address - Fax:360-694-0722
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602665901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice