Provider Demographics
NPI:1255155420
Name:DUNTON, ALIZABETH CHARISE
Entity type:Individual
Prefix:
First Name:ALIZABETH
Middle Name:CHARISE
Last Name:DUNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALIZABETH
Other - Middle Name:CHARISE
Other - Last Name:DUNTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2584 RW JOHNSON BLVD SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512
Mailing Address - Country:US
Mailing Address - Phone:360-878-6434
Mailing Address - Fax:
Practice Address - Street 1:2584 RW JOHNSON BLVD SW
Practice Address - Street 2:SUITE 100
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512
Practice Address - Country:US
Practice Address - Phone:360-878-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician