Healthcare Provider Details

I. General information

NPI: 1932885977
Provider Name (Legal Business Name): MS. ALIYAH MARIE CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 E SPRAGUE AVE
SPOKANE WA
99202-3125
US

IV. Provider business mailing address

2500 HEWITT AVE
EVERETT WA
98201-3789
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-4651
  • Fax:
Mailing address:
  • Phone: 425-565-5589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG61462193
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMCHA.MC.70154058
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: