Provider Demographics
NPI:1831152065
Name:INOUYE, ALICE M (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:INOUYE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4525
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:877-767-2310
Practice Address - Street 1:15214 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6143
Practice Address - Country:US
Practice Address - Phone:206-518-9021
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AI1421825OtherDEA REG.
VAP00135100Medicare ID - Type UnspecifiedRR MEDCR-CES
003646C51Medicare ID - Type UnspecifiedCARILION EMERG.SVCS.
C84668Medicare UPIN