Amanda Sue Macklin, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60784445 Issued in WA

Practice address

630 N Fairview Dr # 256
Tacoma, WA 98406-1015

Phone

(253) 777-1423

NPI assigned

Aug 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fandm Healthcare, LLCGroup PAC ID 8628462983, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• F&M Healthcare, LLC

  dba F&M Healthcare

  • Internal Medicine Physician
  • University Place, WA
  • NPI 1861145120
  Medicare reassignment Care Compare group NPD
• Maksportsmd

  • Sports Medicine (Family Medicine) Physician
  • Bothell, WA
  • NPI 1417469404
  Medicare reassignment NPD
• Therapy Management Services, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bothell, WA
  • NPI 1811252729
  NPD (past)

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1740707967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SW HAYWORTH DR UNIT 203",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983675015",
            "telephone_number": "253-313-2284",
            "fax_number": "253-276-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N FAIRVIEW DR # 256",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984061015",
            "telephone_number": "253-777-1423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 SW Hayworth Dr Unit 203",
            "address_purpose": "LOCATION",
            "city": "Port Orchard",
            "state": "WA",
            "postal_code": "983675015",
            "country_code": "US",
            "telephone_number": "253-313-2284",
            "fax_number": "253-276-6907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "N360791741",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60784445",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60784445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2087977",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel G Mack Jr.
• Susan M Mack, PT
• Matthew Mackarevich, DO
• Merilee Mackay, LPN
• Jamie Mackenzie, COTA/L
• Latasha Macklin, LMHCA
• Alan F Macks, DMD
• Dawn M. Maclennan, C.N.M.
• Douglas A Macleod
• Shawn Allen Macleod, MD

• Gerontology Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.