Provider Demographics
NPI:1710484035
Name:ALDRED, ALISON DIANE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:DIANE
Last Name:ALDRED
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 S MANITO BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2451
Mailing Address - Country:US
Mailing Address - Phone:503-307-6988
Mailing Address - Fax:
Practice Address - Street 1:610 S SHERMAN ST STE 201
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1342
Practice Address - Country:US
Practice Address - Phone:509-458-7720
Practice Address - Fax:509-777-0432
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60727172225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60727172OtherLMT