Provider Demographics
NPI:1376213991
Name:ALLWORTH, AIMEE (LCGC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:ALLWORTH
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S L ST FL 3
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4289
Mailing Address - Country:US
Mailing Address - Phone:253-403-3476
Mailing Address - Fax:253-403-2757
Practice Address - Street 1:311 S L ST FL 3
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4289
Practice Address - Country:US
Practice Address - Phone:253-403-3476
Practice Address - Fax:253-403-2757
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS