Provider Demographics
NPI:1740590967
Name:WARREN, ALISON L (LAC, EAMP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:WARREN
Suffix:
Gender:F
Credentials:LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12724 LAKE CITY WAY NE
Mailing Address - Street 2:#A304
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4450
Mailing Address - Country:US
Mailing Address - Phone:206-518-3127
Mailing Address - Fax:
Practice Address - Street 1:12724 LAKE CITY WAY NE
Practice Address - Street 2:#A304
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4450
Practice Address - Country:US
Practice Address - Phone:206-518-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60178319171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist