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General NPI Number Information
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NPI Number | 1942813878
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Entity Type | Individual
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Provider Name | ALYSSA POGHEN DNP, AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 08/29/2020
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 5520 BRIDGEPORT WAY W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98467-2041
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Country | US
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Telephone | 253-566-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 23920 229TH PL SE
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City | MAPLE VALLEY
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State | WA
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Zip | 98038-5051
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Country | US
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Telephone | 206-830-8729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP61186875
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN60600430
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License Number State | WA
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