Provider Demographics
NPI:1265457576
Name:MURRAY, ALISA LYNN (PHD, E-RYT)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:LYNN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHD, E-RYT
Other - Prefix:DR
Other - First Name:ALISA
Other - Middle Name:LYNN
Other - Last Name:OSTGARD-MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:26461 104TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7668
Mailing Address - Country:US
Mailing Address - Phone:253-242-8828
Mailing Address - Fax:
Practice Address - Street 1:26461 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7668
Practice Address - Country:US
Practice Address - Phone:253-242-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002020103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist