Healthcare Provider Details

I. General information

NPI: 1962331835
Provider Name (Legal Business Name): DEBORAH RENEE ALFANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W CUSHING ST
ABERDEEN WA
98520-8218
US

IV. Provider business mailing address

403 W CUSHING ST
ABERDEEN WA
98520-8218
US

V. Phone/Fax

Practice location:
  • Phone: 360-268-2274
  • Fax:
Mailing address:
  • Phone: 360-268-2274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number604160989
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: