Provider Demographics
NPI:1093236994
Name:VLCEK, ALLISON MAURA
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MAURA
Last Name:VLCEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 S SULLIVAN RD APT 334
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8824
Mailing Address - Country:US
Mailing Address - Phone:206-419-9051
Mailing Address - Fax:
Practice Address - Street 1:511 S SULLIVAN RD APT 334
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8824
Practice Address - Country:US
Practice Address - Phone:206-419-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60550803225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist