Provider Demographics
NPI:1508359225
Name:MITCHELL, ALLISON PERRY (CNM)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:PERRY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:BESS
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:5120 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2612
Mailing Address - Country:US
Mailing Address - Phone:808-284-5288
Mailing Address - Fax:
Practice Address - Street 1:11102 SUNRISE BLVD E STE 110
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:WA
Practice Address - Zip Code:98374-8846
Practice Address - Country:US
Practice Address - Phone:253-697-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60958300207V00000X
GARN261772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology