Provider Demographics
NPI:1912095845
Name:VAWTER, AMY J (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:VAWTER
Suffix:
Gender:F
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 1:3514 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-1532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 S 40TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3800
Practice Address - Country:US
Practice Address - Phone:509-972-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005077363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant