Provider Demographics
NPI:1891414983
Name:LLAMAS, ALEC SODAPOP
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:SODAPOP
Last Name:LLAMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 W EMERSON ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1571
Mailing Address - Country:US
Mailing Address - Phone:805-901-9934
Mailing Address - Fax:
Practice Address - Street 1:1715 NE COLUMBIA RD UNIVERSITY OF WASHINGTON
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-4722
Practice Address - Country:US
Practice Address - Phone:206-221-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician