Provider Demographics
NPI:1871727313
Name:ZABOHNE, AMANDA (LMP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ZABOHNE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BUDNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2506 CONGER CT NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4432
Mailing Address - Country:US
Mailing Address - Phone:360-528-9648
Mailing Address - Fax:
Practice Address - Street 1:209 4TH AVE E STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-6967
Practice Address - Country:US
Practice Address - Phone:360-528-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60019094225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist