AMANDA D PETERSEN (NPI# 1528391372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528391372 |
| Entity Type | Individual |
| Full Name | AMANDA D PETERSEN |
| Credential | PA-C |
| Practice Address |
4804 W Clearwater Ave Kadlec Clinic Urgent Care Kennewick WA 99336 |
| Mailing Address |
3900 S Zintel Way Kennewick WA 99337 |
| Practice Telephone | 5099422355 |
| Practice Fax Number | 5092222355 |
| Mailing Telephone | 5099423627 |
| Mailing Fax Number | 5099422268 |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2014-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60113833 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PENDING | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1528391372 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881239499 | Amanda Petersen | Nurse Practitioner | Utmb Health--department of Surgery 301 University Blvd, 6.146 John Sealy Annex, Galveston, TX 77555-0527 | 2019-11-07 |
| 1689163222 | Amanda Petersen | Nurse Practitioner | 775 Pole Line Rd W Ste 113, Twin Falls, ID 83301-5819 | 2018-05-09 |
| 1487908547 | Amanda Petersen | Health Educator | 103 E Macarthur Ave, Bloomington, IL 61701-5234 | 2012-10-28 |
| 1063983724 | Amanda Joan Petersen | Nurse Anesthetist, Certified Registered | Duluth Clinic, 400 East Third Street, Duluth, MN 55805-1951 | 2018-12-06 |
| 1154760627 | Amanda Ruth Petersen | Counselor | 2200 4th St, Baker City, OR 97814-2615 | 2013-06-18 |
| 1962746818 | Amanda Lee Petersen | Occupational Therapist | 90 Howard Dr, Shelbyville, KY 40065-8138 | 2012-11-15 |
| 1215186192 | Amanda Ward Petersen | Physical Therapy Assistant | 1610 N Queen St, Kinston, NC 28501-2947 | 2008-09-16 |
| Street Address |
4804 W CLEARWATER AVE KADLEC CLINIC URGENT CARE |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396737706 | Vickie Boll | Physician Assistant | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2005-08-22 |
| 1043767122 | Mindy Barber | Nurse Practitioner | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2016-09-06 |
| 1205233400 | Joshua Hughes | Family Medicine | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2014-12-03 |
| 1053654913 | Paul A Shoemaker | Registered Nurse | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2013-03-28 |
| 1649542838 | Laura J Campos | Licensed Practical Nurse | 4804 W Clearwater Ave, Kennewick, WA 99336 | 2012-02-02 |
| 1982657938 | Franklin C Newhouse | Family Medicine | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2006-05-19 |
| 1841277340 | Bevan W Briggs | Nurse Practitioner | 4804 W Clearwater Ave, Kennewick, WA 99336-2119 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393888 | Kelsie D Parvinen | Massage Therapist | 8350 W. Grandridge Blvd, Suite 100, Kennewick, WA 99336 | 2019-12-16 |
| 1508403858 | New U Women's Clinic & Aesthetics Pllc | Nurse Practitioner | 35 S Louisiana St, Suite A120, Kennewick, WA 99336 | 2019-12-05 |
| 1457901944 | Solar Mobility LLC | Durable Medical Equipment & Medical Supplies | 949 S Keller St, Kennewick, WA 99336 | 2019-09-17 |
| 1023662590 | Shane Arthur Gulley | Counselor | 500 N. Morain St Suite 1250, Kennewick, WA 99336 | 2019-08-01 |
| 1063973873 | Farah Saleem | Student in an Organized Health Care Education/Training Program | 212 W. 10th Avenue,suite 202, Kennewick, WA 99336 | 2019-03-26 |
| 1255897690 | Thomas Stanley Mcgowan | Student in an Organized Health Care Education/Training Program | Tri-cities Cancer Center, 7350 W. Deschutes Ave, Building A, Kennewick, WA 99336 | 2019-02-11 |
| 1770068280 | Remedy Urgent Mobile Medicine Pllc | Nurse Practitioner | 3311 West Clearwater Avenue, Suite D210, Kennewick, WA 99336 | 2018-10-01 |
| 1740767011 | Zachary Wilber Fournier | Specialist/Technologist | Toyota Center - 7000 West Grandridge Blvd, Kennewick, WA 99336 | 2018-07-19 |
| 1649780693 | Alan Arnold Hanson | Chiropractor | 8350 W. Grandridge Blvd #100, Kennewick, WA 99336 | 2017-10-04 |
| 1922528827 | Sarah Nicole Childress | Counselor | 415 North Morain St, Kennewick, WA 99336 | 2017-06-21 |
| Find all providers in zip 99336 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1861656902 | Anthony Vincent Carabba | Physician Assistant | 4303 W 27th Ave Ste D, Kennewick, WA 99338-1986 | 2008-07-17 |
| 1992970297 | William S. Waites | Physician Assistant | 3730 Plaza Way Ste C6100, Kennewick, WA 99338-2718 | 2008-04-28 |
| 1609906411 | Bruce Patrick Deleonard | Physician Assistant | Kania Clinic 3000 W Kennewick Rd., Kennewick, WA 99301 | 2007-03-07 |
| 1477635159 | Steven R Zirker | Physician Assistant | 4008 W 27th Ave, Suite 103, Kennewick, WA 99337 | 2006-10-20 |
| 1275022964 | James Mathew Petersen | Physician Assistant | 3730 Plaza Way Ste C6100, Kennewick, WA 99338-2718 | 2018-05-08 |
| 1467972646 | Timothy Salvos | Physician Assistant | 6710 W Okanogan Pl, Kennewick, WA 99336-8001 | 2017-06-20 |
| 1346778271 | Jeremiah Hendricks Price | Physician Assistant | 2828 S Olympia St, Kennewick, WA 99337-4356 | 2017-05-23 |
| 1841735388 | Laura Cunningham | Physician Assistant | 6802 W Rio Grande Ave Ste 1, Kennewick, WA 99336-7684 | 2016-12-19 |
| 1184171290 | Pinnicale Pain Center | Physician Assistant | 3730 Plaza Way Ste C6100, Kennewick, WA 99338-2718 | 2016-09-07 |
| Find all providers in KENNEWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.