Provider Demographics
NPI:1578941373
Name:POWER, ALYSE (MD)
Entity Type:Individual
Prefix:
First Name:ALYSE
Middle Name:
Last Name:POWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5377 MANHATTAN CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-4344
Mailing Address - Country:US
Mailing Address - Phone:720-273-3568
Mailing Address - Fax:
Practice Address - Street 1:5377 MANHATTAN CIR STE 103
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4344
Practice Address - Country:US
Practice Address - Phone:720-273-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001140208M00000X
AK100836207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine