Basic Information
Provider Information
NPI: 1912272790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWNS
FirstName: AMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8687 E VIA DE VENTURA
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852583347
CountryCode: US
TelephoneNumber: 4809709097
FaxNumber:  
Practice Location
Address1: 4526 FEDERAL AVE
Address2:  
City: EVERETT
State: WA
PostalCode: 982032132
CountryCode: US
TelephoneNumber: 4253496200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/13/2012
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5005596NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LP0808X17629SCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health
363LP0808XAP60802533WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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