Provider Demographics
NPI:1881921211
Name:WILLIAMS, AMELIA D (PA-C)
Entity type:Individual
Prefix:MISS
First Name:AMELIA
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 E SINTO AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1081
Mailing Address - Country:US
Mailing Address - Phone:509-922-2055
Mailing Address - Fax:509-922-2307
Practice Address - Street 1:12401 E SINTO AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1081
Practice Address - Country:US
Practice Address - Phone:509-922-2055
Practice Address - Fax:509-922-2307
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60109946363AM0700X
IDPA-2520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical