Provider Demographics
NPI:1861758088
Name:ALMEIDA, AMY HANAKO (ATC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:HANAKO
Last Name:ALMEIDA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17650 140TH AVE SE
Practice Address - Street 2:B7
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6814
Practice Address - Country:US
Practice Address - Phone:425-430-0700
Practice Address - Fax:425-430-0071
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 602773792083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine