Provider Demographics
NPI:1528600855
Name:IRONS, ALYSHA DIANE
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:DIANE
Last Name:IRONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-9302
Mailing Address - Country:US
Mailing Address - Phone:360-855-3500
Mailing Address - Fax:
Practice Address - Street 1:801 TRAIL RD
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-9302
Practice Address - Country:US
Practice Address - Phone:360-855-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60687187164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse