Provider Demographics
NPI:1720262819
Name:ESSERS, ALICIA M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:ESSERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6205
Mailing Address - Country:US
Mailing Address - Phone:602-920-5239
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 1500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-386-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7051235Z00000X
WALL60297466235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist