Provider Demographics
NPI:1497414460
Name:DAVIE, ALYCE JUNE (AGENCY AFFILIATED CO)
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:JUNE
Last Name:DAVIE
Suffix:
Gender:F
Credentials:AGENCY AFFILIATED CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 PACIFIC AVE STE C3
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-7423
Mailing Address - Country:US
Mailing Address - Phone:253-363-8853
Mailing Address - Fax:
Practice Address - Street 1:6201 PACIFIC AVE STE C3
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7423
Practice Address - Country:US
Practice Address - Phone:253-363-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist