Basic Information
| Provider Information | |||||||||
| NPI: | 1811505316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINNEY | ||||||||
| FirstName: | AMELIA | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | LSWAA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HUDSON | ||||||||
| OtherFirstName: | AMELIA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 27349 GAMBLE BAY RD NE | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983469540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605363492 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 400 WARREN AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983371467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604756701 | ||||||||
| FaxNumber: | 3603732096 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2020 | ||||||||
| LastUpdateDate: | 07/21/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 07/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 60996806 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.