Provider Demographics
NPI:1720864952
Name:DUBE, AISLING FINLAY LYRA (LSWAIC)
Entity Type:Individual
Prefix:MRS
First Name:AISLING
Middle Name:FINLAY LYRA
Last Name:DUBE
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:AMBER
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:522 N ST
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550-3411
Mailing Address - Country:US
Mailing Address - Phone:360-228-6735
Mailing Address - Fax:
Practice Address - Street 1:522 N ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-3411
Practice Address - Country:US
Practice Address - Phone:360-228-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61402034163W00000X
WASC614475741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse