Healthcare Provider Details

I. General information

NPI: 1376451641
Provider Name (Legal Business Name): ALYSSA JASMINE SERRATO MASS.MA.70132483
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

938 W 3RD AVE
MOSES LAKE WA
98837-2011
US

IV. Provider business mailing address

2309 W LAKESIDE DR
MOSES LAKE WA
98837-2816
US

V. Phone/Fax

Practice location:
  • Phone: 509-350-4785
  • Fax:
Mailing address:
  • Phone: 509-771-5802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70132483
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: