Provider Demographics
NPI:1730454786
Name:HUNTER, AMBER NICOLE (LMP)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NICOLE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4215 S 30TH ST
Mailing Address - Street 2:APARTMENT F239
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-3246
Mailing Address - Country:US
Mailing Address - Phone:360-515-1939
Mailing Address - Fax:
Practice Address - Street 1:20930 108TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1101
Practice Address - Country:US
Practice Address - Phone:253-856-8868
Practice Address - Fax:253-856-3654
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60269410225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist