Provider Demographics
NPI:1871950410
Name:SPEER, AMBER JEAN (PTA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JEAN
Last Name:SPEER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4512
Mailing Address - Country:US
Mailing Address - Phone:360-927-7639
Mailing Address - Fax:
Practice Address - Street 1:300 S 18TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4661
Practice Address - Country:US
Practice Address - Phone:360-424-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant