Provider Demographics
NPI:1255026548
Name:PALMER, AMIA ROSE
Entity type:Individual
Prefix:
First Name:AMIA
Middle Name:ROSE
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMIA
Other - Middle Name:ROSE
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8344
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0344
Mailing Address - Country:US
Mailing Address - Phone:509-995-3388
Mailing Address - Fax:509-321-4350
Practice Address - Street 1:227 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3611
Practice Address - Country:US
Practice Address - Phone:509-995-3388
Practice Address - Fax:509-321-4350
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician