Provider Demographics
NPI:1538437389
Name:AMANDA MONWAI
Entity type:Organization
Organization Name:AMANDA MONWAI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-821-1800
Mailing Address - Street 1:12911 120TH AVE NE
Mailing Address - Street 2:A40
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3027
Mailing Address - Country:US
Mailing Address - Phone:425-821-1800
Mailing Address - Fax:425-821-1818
Practice Address - Street 1:12911 120TH AVE NE
Practice Address - Street 2:A40
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3027
Practice Address - Country:US
Practice Address - Phone:425-821-1800
Practice Address - Fax:425-821-1818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMANDA MONWAI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-08
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site