Healthcare Provider Details

I. General information

NPI: 1154259430
Provider Name (Legal Business Name): ALYSSA N LANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19449 RENTON MAPLE VALLEY RD SE UNIT A
MAPLE VALLEY WA
98038-8932
US

IV. Provider business mailing address

19449 RENTON MAPLE VALLEY RD SE UNIT A
MAPLE VALLEY WA
98038-8932
US

V. Phone/Fax

Practice location:
  • Phone: 206-304-7332
  • Fax:
Mailing address:
  • Phone: 206-304-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.61168651
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: