Provider Demographics
NPI:1972658961
Name:ALYEA, ALAN D (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:ALYEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E ROWAN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1202
Mailing Address - Country:US
Mailing Address - Phone:509-489-2851
Mailing Address - Fax:509-484-0103
Practice Address - Street 1:220 E ROWAN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1202
Practice Address - Country:US
Practice Address - Phone:509-489-2851
Practice Address - Fax:509-484-0103
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025007207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8112252Medicaid
WA2744OtherE WA GROUP HEALTH
WA8112252Medicaid
WAAB00129Medicare ID - Type Unspecified