Provider Demographics
NPI:1770939647
Name:ROBERTSON, ALESHA ERIN (BT)
Entity type:Individual
Prefix:
First Name:ALESHA
Middle Name:ERIN
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:ALESHA
Other - Middle Name:ERIN
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:227 SYMONS ST STE A
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3423
Mailing Address - Country:US
Mailing Address - Phone:509-594-9358
Mailing Address - Fax:
Practice Address - Street 1:1919 N PITTSBURG ST STE B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7216
Practice Address - Country:US
Practice Address - Phone:920-857-9041
Practice Address - Fax:920-857-3366
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60653422225700000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist