Provider Demographics
NPI:1033867460
Name:SORRENTINO, AMANDA E (LMT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 W CLEARWATER AVE UPPR UNITB
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1683
Mailing Address - Country:US
Mailing Address - Phone:720-436-7668
Mailing Address - Fax:509-581-6123
Practice Address - Street 1:7411 W CLEARWATER AVE UPPR UNITB
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1683
Practice Address - Country:US
Practice Address - Phone:360-504-8904
Practice Address - Fax:509-581-6123
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61280936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist