Provider Demographics
NPI:1578081980
Name:ABEGG-GARCIA, ALYSSA CARYN (ARNP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CARYN
Last Name:ABEGG-GARCIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:CARYN
Other - Last Name:ABEGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1610 N HUSON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-3338
Mailing Address - Country:US
Mailing Address - Phone:720-839-3576
Mailing Address - Fax:
Practice Address - Street 1:237 PROFESSIONAL WAY
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-4404
Practice Address - Country:US
Practice Address - Phone:360-426-2500
Practice Address - Fax:360-462-2500
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60668727163W00000X
WAAP60781552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse