Provider Demographics
NPI:1609750363
Name:CULVER, AMANDA LOUISE (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LOUISE
Last Name:CULVER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 SE 192ND AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7415
Mailing Address - Country:US
Mailing Address - Phone:360-210-5440
Mailing Address - Fax:
Practice Address - Street 1:900 NE 139TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685
Practice Address - Country:US
Practice Address - Phone:360-573-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60186321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist