Organization · NPI-2

Amoma, PLLC

Psychiatry & Neurology, Psychiatry · Spokane, WA

NPI number1215475744
StatusActive
Last updated in NPPESMay 24, 2023

Details

NPI
1215475744
Entity type
Organization (NPI-2)
Legal business name
Amoma, PLLC
Organization subpart
No
Enumeration date
Feb 3, 2017
Certification date
May 24, 2023
Last updated
May 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, PsychiatryAP60643395WAYes
251J00000X Nursing Care–FL
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)–FL
261QM0850X Clinic/Center, Adult Mental HealthAP60643395WA

Other names

  • Amoma, LLC (Other Name)

Practice location

1314 S Grand Blvd Ste 2
Spokane, WA 99202-1174

Phone 813-955-2827 · Fax 866-611-7552

Mailing address

3690 W Gandy Blvd
Tampa, FL 33611-2608

Phone 509-228-8323

Authorized official

Archiel Buagas-Kintanar
Provider/Owner
5092288323

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