Provider Demographics
NPI:1871943985
Name:AMANDUS, JAMES A (LMHC-A)
Entity type:Individual
Prefix:DR
First Name:JAMES A
Middle Name:
Last Name:AMANDUS
Suffix:
Gender:M
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 CEDAR AVE S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5078
Mailing Address - Country:US
Mailing Address - Phone:206-293-7323
Mailing Address - Fax:
Practice Address - Street 1:1160 140TH AVE NE
Practice Address - Street 2:SUITE F
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2978
Practice Address - Country:US
Practice Address - Phone:425-454-0616
Practice Address - Fax:425-637-1289
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60663242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health