Amanda Edwards Stewart, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60141928 Issued in WA

Practice address

Madigan Army Medical Ctr
Attn: Credentials
Tacoma, WA 98431-1100

Phone

(253) 968-3287

Fax

(253) 968-4192

NPI assigned

Sep 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Amanda Rachel Edwards Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1619286416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "9040 JACKSON AVE ATTN: CREDENTIALS",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1290",
            "fax_number": "253-968-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "ATTN: CREDENTIALS",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-3287",
            "fax_number": "253-968-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "AMANDA",
        "middle_name": "EDWARDS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60141928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911636568",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "EDWARDS",
            "middle_name": "RACHEL",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Jean Kathleen Stevens, BT
• Samuel Stevens, MD
• Julie Stevenson
• Matthew T Stevenson, MD
• Aaron William Stewart, MD
• Cristina Dorothy Patricia Stewart, LMP
• David Charles Stewart, M.D.
• David Lee Stewart, LPN
• Emily Olivia Stewart
• Jeffrey Allen Stewart, DDS

• Clinical Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.