Provider Demographics
NPI:1548698442
Name:RADOVICH, AMANDA (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RADOVICH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 BROADWAY FL 7
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5330
Mailing Address - Country:US
Mailing Address - Phone:425-820-1221
Mailing Address - Fax:425-821-9362
Practice Address - Street 1:4455 148TH AVE NE # B1
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3120
Practice Address - Country:US
Practice Address - Phone:063-862-6002
Practice Address - Fax:425-296-3622
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2025-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA60421555363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical