Basic Information
| Provider Information | |||||||||
| NPI: | 1457797961 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FREED | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | SARAH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 9TH AVE | ||||||||
| Address2: | M4-PFS | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981012756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065155811 | ||||||||
| FaxNumber: | 2063410274 | ||||||||
| Practice Location | |||||||||
| Address1: | 2671 NE 46TH ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981055041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065258000 | ||||||||
| FaxNumber: | 2065258070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2013 | ||||||||
| LastUpdateDate: | 02/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SG0201X | 60745494 | WA | N | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) | 208000000X | 60745494 | WA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 60745494 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.