Provider Demographics
NPI:1780430728
Name:WANG, ALICIA ELIZABETH (CPT MS)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ELIZABETH
Last Name:WANG
Suffix:
Gender:F
Credentials:CPT MS
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ELIZABETH
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1303 COMMERCIAL ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4348
Mailing Address - Country:US
Mailing Address - Phone:408-569-9694
Mailing Address - Fax:
Practice Address - Street 1:4125 ARCTIC AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9325
Practice Address - Country:US
Practice Address - Phone:360-671-6947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach