Provider Demographics
NPI:1497075436
Name:SCHAFER, ALYSSA (LMP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:SCHAFER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 S TACOMA WAY STE 106
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4490
Mailing Address - Country:US
Mailing Address - Phone:253-588-8340
Mailing Address - Fax:253-588-8341
Practice Address - Street 1:9701 S TACOMA WAY STE 106
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4490
Practice Address - Country:US
Practice Address - Phone:253-588-8340
Practice Address - Fax:253-588-8341
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60112114225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist