MEDICARE: ALVIN CURRIE AA/CDP

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP00003233	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CP00003233	OTHER	WA	WASHINGTON DOL

General Provider Information

NPI Number	:	1568653111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALVIN CURRIE AA/CDP

Provider Business Mailing Address
First Line	:	12650 1ST AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98168-2617
Country	:	US
Telephone Number	:	206-248-3006
Fax Number	:	206-248-3029

Provider Business Practice Location Address
First Line	:	12650 1ST AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98168-2617
Country	:	US
Telephone Number	:	206-248-3006
Fax Number	:	206-248-3029

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	08/08/2007

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