MEDICARE: MR. BRYCE ALIKZANDR SHOEMAKER MA, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH 60582917	WA

General Provider Information

NPI Number	:	1558702316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRYCE ALIKZANDR SHOEMAKER MA, LMHC

Provider Business Mailing Address
First Line	:	212 BROADWAY E UNIT 20775
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-7080
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4860 RAINIER AVE S STE C
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-6305
Country	:	US
Telephone Number	:	206-339-7327
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2013
Last Update Date	:	02/25/2024

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