Basic Information
| Provider Information | |||||||||
| NPI: | 1033687710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIONDO | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 558 MCGRAW ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981092241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186692054 | ||||||||
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| Practice Location | |||||||||
| Address1: | 531 BROADWAY E STE 10 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981025023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036848252 | ||||||||
| FaxNumber: | 8668598195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2018 | ||||||||
| LastUpdateDate: | 10/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 009076 | NY | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 163W00000X | 61302594 | WA | N | Nursing Service Providers | Registered Nurse | 363LP0808X | AP61332817 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.