Provider Demographics
NPI:1952686859
Name:GARRETT, ALYSSA (LMP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N UNIVERSITY RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206
Mailing Address - Country:US
Mailing Address - Phone:509-999-2535
Mailing Address - Fax:509-847-0162
Practice Address - Street 1:1209 N UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206
Practice Address - Country:US
Practice Address - Phone:509-999-2535
Practice Address - Fax:509-847-0162
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60180755225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist