Provider Demographics
NPI:1407329360
Name:DAVIES, ALAIA PAULINE WESLI
Entity Type:Individual
Prefix:MRS
First Name:ALAIA
Middle Name:PAULINE WESLI
Last Name:DAVIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALAIA
Other - Middle Name:PAULINE WESLI
Other - Last Name:HABBEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:21838 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-3723
Mailing Address - Country:US
Mailing Address - Phone:425-442-1361
Mailing Address - Fax:
Practice Address - Street 1:23261 NE 17TH ST
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-4447
Practice Address - Country:US
Practice Address - Phone:425-442-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARBT-17-45850106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician