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NPI Code Detail

MEDICARE: ALISA MARIE HUFFMAN MSW, LICSW

MEDICARE: ALISA MARIE HUFFMAN MSW, LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLW 60621424WA
2101Y00000XCounselor
3104100000XSocial WorkerLW 60621424WA
4104100000XSocial WorkerSC 60343773WA
51041C0700XClinical Social WorkerSC 60343773WA

General Provider Information

NPI Number : 1215294715
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISA MARIE HUFFMAN MSW, LICSW
Provider Business Mailing Address
First Line : 522 W RIVERSIDE AVE # 8144
Second Line :
City : SPOKANE
State : WA
Zip : 99201-0580
Country : US
Telephone Number : 253-237-6175
Fax Number :
Provider Business Practice Location Address
First Line : 101 ELLIOTT AVE W STE 500
Second Line :
City : SEATTLE
State : WA
Zip : 98119-4292
Country : US
Telephone Number : 253-237-6175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2012
Last Update Date : 06/24/2024

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