Provider Demographics
NPI:1851891014
Name:LOFGREN, ALISON KAY
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:KAY
Last Name:LOFGREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:KAY
Other - Last Name:HOFMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 PACIFIC PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-5463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 PACIFIC PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5463
Practice Address - Country:US
Practice Address - Phone:360-416-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60799104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist