Provider Demographics
NPI:1477061760
Name:FRAZIER, ARLEN ROSE (MA)
Entity type:Individual
Prefix:
First Name:ARLEN
Middle Name:ROSE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ARLEN
Other - Middle Name:
Other - Last Name:KASPIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 55757
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-0757
Mailing Address - Country:US
Mailing Address - Phone:206-226-6020
Mailing Address - Fax:
Practice Address - Street 1:15879 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-6335
Practice Address - Country:US
Practice Address - Phone:206-226-6020
Practice Address - Fax:206-364-1410
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004908101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor