1821478546 NPI number — MRS. ALYSSA BETH RICE MSW, MHP, CG

Table of content: MRS. ALYSSA BETH RICE MSW, MHP, CG (NPI 1821478546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821478546 NPI number — MRS. ALYSSA BETH RICE MSW, MHP, CG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICE
Provider First Name:
ALYSSA
Provider Middle Name:
BETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, MHP, CG
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAWYER
Provider Other First Name:
ALYSSA
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1821478546
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1678
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98668-1678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-397-8246
Provider Business Mailing Address Fax Number:
360-397-8448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 E 4TH PLAIN BLVD
Provider Second Line Business Practice Location Address:
BLDG #17
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98661-3753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-397-8246
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  CG60562981 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com