Amanda Wilson, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00022187 Issued in WA

Practice address

19950 S Prairie Rd E
Bonney Lake, WA 98391-7901

Phone

(253) 862-1555

Fax

(253) 862-1557

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1043341589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19950 S PRAIRIE RD E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917901",
            "telephone_number": "253-862-1555",
            "fax_number": "253-862-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19950 S PRAIRIE RD E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917901",
            "telephone_number": "253-862-1555",
            "fax_number": "253-862-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00022187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas C Welter, MD
• Stephen Alfred Wessenberg, PTA, BS, AS
• Esravila Ariya Wibisono, MD
• Sheila M Wiley, LMP
• Kelsey Williams, RN, BSN
• Kathryn Frances Wire, DPT
• Victoria F Wirtz, D.C.
• Cheron L. Wittman, PA-C
• Jacob Thomas Wright, DPT
• Carla Yamashiro DDS, DDS

• Specialist in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.