Provider Demographics
NPI:1184951162
Name:MCELROY, ALICIA CHRISTINE (LMP)
Entity type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:CHRISTINE
Last Name:MCELROY
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 1:4564 168TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-9025
Mailing Address - Country:US
Mailing Address - Phone:425-785-5820
Mailing Address - Fax:
Practice Address - Street 1:4564 168TH AVE SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-9025
Practice Address - Country:US
Practice Address - Phone:425-785-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60112864225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist