Provider Demographics
NPI:1891250312
Name:DURR, ALEETA YVONNE
Entity Type:Individual
Prefix:
First Name:ALEETA
Middle Name:YVONNE
Last Name:DURR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALEETA
Other - Middle Name:YVONNE
Other - Last Name:DURR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHEMICAL DEPENDENCY
Mailing Address - Street 1:20508 56TH AVE W # 101
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7650
Mailing Address - Country:US
Mailing Address - Phone:425-870-5262
Mailing Address - Fax:
Practice Address - Street 1:20508 56TH AVE W # 101
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7650
Practice Address - Country:US
Practice Address - Phone:425-870-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)