Provider Demographics
NPI:1689176067
Name:DEMERS, ALYSSA ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:ANN
Last Name:DEMERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:ANN
Other - Last Name:HABNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3851 SUNNYSLOPE RD SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-9124
Mailing Address - Country:US
Mailing Address - Phone:360-775-6282
Mailing Address - Fax:253-284-9314
Practice Address - Street 1:723 NE RIDDELL RD STE A
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3030
Practice Address - Country:US
Practice Address - Phone:800-769-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61296412363L00000X
WARN60759095163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health