MEDICARE: ALLYSON YLVISAKER

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	CO70106443	WA
2	101YM0800X	Mental Health Counselor	MC70043326	WA

General Provider Information

NPI Number	:	1609601905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON YLVISAKER

Provider Business Mailing Address
First Line	:	6400 SOUTHCENTER BLVD
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 E OLIVE ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-2735
Country	:	US
Telephone Number	:	206-901-2000
Fax Number	:

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	03/13/2026

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Directions to “ ALLYSON YLVISAKER ” Practice Location

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