Provider Demographics
NPI:1356812036
Name:SCHIECHE, ALISSA S (CDPT)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:S
Last Name:SCHIECHE
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2765
Mailing Address - Country:US
Mailing Address - Phone:425-271-5600
Mailing Address - Fax:
Practice Address - Street 1:1025 S 3RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2765
Practice Address - Country:US
Practice Address - Phone:425-271-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60546015101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60546015OtherCHEMICAL DEPENDENCY PROFESSIONAL TRAINEE