Provider Demographics
NPI:1477882579
Name:MORRIS, ALICE G (LW 60652280)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:G
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LW 60652280
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22530 SE 64TH PLACE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5353
Mailing Address - Country:US
Mailing Address - Phone:425-677-8686
Mailing Address - Fax:425-961-0783
Practice Address - Street 1:22530 SE 64TH PLACE
Practice Address - Street 2:SUITE 220
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5353
Practice Address - Country:US
Practice Address - Phone:425-677-8686
Practice Address - Fax:425-961-0783
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW604055301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO392OtherDORA