Provider Demographics
NPI:1043378490
Name:PARAISO, ALICIA AUSTRIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:AUSTRIA
Last Name:PARAISO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24720 132ND CT SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6665
Mailing Address - Country:US
Mailing Address - Phone:253-630-5733
Mailing Address - Fax:
Practice Address - Street 1:20 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5404
Practice Address - Country:US
Practice Address - Phone:206-205-6855
Practice Address - Fax:206-296-8403
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001043363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9609587Medicaid
WAS73054Medicare UPIN