Provider Information for 1417423112
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Mrs. AMANDA KAE NORE MCLEAN MSW, CMHS
Other Names:Former Name:Miss AMANDA KAE NORESex: Female
NPI: 1417423112
Last Updated: 2020-01-09
Certification Date: 2020-01-09
Certification Date: 2020-01-09
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1417423112 | ||||||||||||
| Enumeration Date | 2018-10-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 550 GAGE BLVD STE 101 RICHLAND, WA 99352-9532 United States Phone: 509-942-3627 | Fax:509-627-2983 | ||||||||||||
| Primary Practice Address | 3900 S ZINTEL WAY FL 2 KENNEWICK, WA 99337-5092 United States Phone: 509-942-3125 | Fax:509-585-8173 | ||||||||||||
| Secondary Practice Address(es) | 3321 W KENNEWICK AVE STE 150 | ||||||||||||
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