Provider Demographics
NPI:1912921735
Name:WILLIAMS, ALICE ANNE (LMP)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:ANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 W 34TH ST
Mailing Address - Street 2:P133
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-1289
Mailing Address - Country:US
Mailing Address - Phone:360-773-8710
Mailing Address - Fax:
Practice Address - Street 1:300 W 39TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-1960
Practice Address - Country:US
Practice Address - Phone:360-773-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016374174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist