Provider Demographics
NPI:1114454865
Name:KREISMAN, ALIZA (ARNP)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:KREISMAN
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 1:6843 OSWEGO PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6455
Mailing Address - Country:US
Mailing Address - Phone:360-302-0441
Mailing Address - Fax:
Practice Address - Street 1:11020 19TH AVENUE SE
Practice Address - Street 2:KAISER PERMANENTE OF WASHINGTON SEATTLE CARE CLINIC
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:206-988-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60297560163W00000X
WAAP60759987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse