Basic Information
Provider Information
NPI: 1598033474
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MACHIN
FirstName: AMBER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 960 HARRIS AVE UNIT 302
Address2:  
City: BELLINGHAM
State: WA
PostalCode: 982257009
CountryCode: US
TelephoneNumber: 8065431410
FaxNumber:  
Practice Location
Address1: 602 INDIANA AVE
Address2: EC PHYSICIANS
City: LUBBOCK
State: TX
PostalCode: 794153364
CountryCode: US
TelephoneNumber: 8067759700
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/07/2011
LastUpdateDate: 05/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X60937607WAN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XQ3042TXN Allopathic & Osteopathic PhysiciansPediatrics 
390200000X TXN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207PP0204XQ3042TXY Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine

No ID Information.


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