Provider Demographics
NPI:1518589746
Name:GRISKIEWICZ, ALYSSA KRYSTELLE (LMHC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KRYSTELLE
Last Name:GRISKIEWICZ
Suffix:
Gender:F
Credentials:LMHC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 NE 130TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4341
Mailing Address - Country:US
Mailing Address - Phone:508-523-9691
Mailing Address - Fax:
Practice Address - Street 1:3301 BURKE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9054
Practice Address - Country:US
Practice Address - Phone:508-523-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16-052221700000X
WALH60926995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist