Provider Demographics
NPI:1750683777
Name:WARE, ALICIA EARLINE
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:EARLINE
Last Name:WARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:HOLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3410 19TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-6442
Mailing Address - Country:US
Mailing Address - Phone:206-484-0636
Mailing Address - Fax:
Practice Address - Street 1:414 17TH ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6822
Practice Address - Country:US
Practice Address - Phone:206-484-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist