Provider Demographics
NPI:1871109835
Name:ENGEL, AMANDA LYNN (CRNA)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:LYNN
Last Name:ENGEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5366 93RD PL SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3610
Mailing Address - Country:US
Mailing Address - Phone:425-346-2672
Mailing Address - Fax:
Practice Address - Street 1:5366 93RD PL SW
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3610
Practice Address - Country:US
Practice Address - Phone:425-346-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC128466367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered