Amanda Lyn Paulson, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

ST00003548 Issued in WA

Practice address

3900 Capitol Mall Dr SW
Olympia, WA 98502-8654

Phone

(360) 754-5858

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083828701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 MOTTMAN RD SW",
            "address_2": "#205",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127833",
            "telephone_number": "906-395-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CAPITOL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-754-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "MI",
            "license": "90971",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "WA",
            "license": "ST00003548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul J Allen MD PLLC
• Paul W. Donnelly
• Katie Lorraine Pauley, ARNP
• Nathan Erik Paull
• Nathaniel Beecher Paull, M.D.
• Sherrie Pavlovic, R.N.
• Brookley Morgan Pavnica
• Paymon Kamkar, D.D.S.
• Brad A. Payne, P.T.
• Conley Payne, DDS

• Surgical Technologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Surgical Technologist in Washington

• 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.

Verify at the official NPI Registry.