Active NPI
Guinevere Ilana Amadeo, LMP.
- Specialist
- Mountlake Terrace, WA
National Provider Identifier
1033246293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00022752
- Practice address
- 5104 239TH PL SW
Mountlake Terrace, WA 98043-5625 - Phone
- (206) 948-9823
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00022752 | WA | Primary |
Addresses
Primary practice location
5104 239TH PL SW
Mountlake Terrace, WA 98043-5625
Mailing address
5104 239TH PL SW
Mountlake Terrace, WA 98043-5625
Phone (206) 948-9823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00022752 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033246293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5104 239TH PL SW",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980435625",
"telephone_number": "206-948-9823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5104 239TH PL SW",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980435625",
"telephone_number": "206-948-9823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMADEO",
"first_name": "GUINEVERE",
"middle_name": "ILANA",
"credential": "LMP.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00022752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountlake Terrace, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.