Provider Demographics
NPI:1447471263
Name:CLEWELL, AMY ELIZABETH (ND)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:CLEWELL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10011 SW 188TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070
Mailing Address - Country:US
Mailing Address - Phone:206-463-1673
Mailing Address - Fax:
Practice Address - Street 1:18913 VASHON HIGHWAY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070
Practice Address - Country:US
Practice Address - Phone:206-412-4884
Practice Address - Fax:206-463-4791
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001389175F00000X
WAMA00020478225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist