Healthcare Provider Details

I. General information

NPI: 1962353623
Provider Name (Legal Business Name): ALYSSA MACKAY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 E 2ND AVE
SPOKANE WA
99202-1406
US

IV. Provider business mailing address

504 E 2ND AVE
SPOKANE WA
99202-1406
US

V. Phone/Fax

Practice location:
  • Phone: 509-599-8658
  • Fax:
Mailing address:
  • Phone: 509-202-8853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberSWIA.SC.61575338
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWIA.SC.61575338
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: