1992214480 NPI number — MS. ALICIA HALLEY WEEKS CCC-SLP

Table of content: MS. ALICIA HALLEY WEEKS CCC-SLP (NPI 1992214480)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992214480 NPI number — MS. ALICIA HALLEY WEEKS CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
WEEKS

Provider First Name:
ALICIA

Provider Middle Name:
HALLEY

Provider Name Prefix Text:
MS.

Provider Name Suffix Text:

Provider Credential Text:
CCC-SLP

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992214480

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
10/06/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 40213

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
SPOKANE

Provider Business Mailing Address State Name:
WA

Provider Business Mailing Address Postal Code:
99220-0903

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
509-995-3125

Provider Business Mailing Address Fax Number:
509-612-7776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1523 E 16TH AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
SPOKANE

Provider Business Practice Location Address State Name:
WA

Provider Business Practice Location Address Postal Code:
99203-3617

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
509-995-3125

Provider Business Practice Location Address Fax Number:
509-612-7776

Provider Enumeration Date:
09/27/2017

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: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Taxonomy code: 235Z00000X , with the licence number: LL60851395 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .