Provider Demographics
NPI:1871361857
Name:MCWHERTER, AMANDA RENEE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:MCWHERTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4953 PUGET SOUND LN
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9766
Mailing Address - Country:US
Mailing Address - Phone:360-988-1406
Mailing Address - Fax:
Practice Address - Street 1:4953 PUGET SOUND LN
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-9766
Practice Address - Country:US
Practice Address - Phone:360-988-1406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60243558364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health