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NPI Code Detail

MEDICARE: MRS. ALYSSA KAYE CARLSON

MEDICARE:  MRS. ALYSSA KAYE CARLSON
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
1235Z00000XSpeech-Language PathologistSI 60516434WA

General Provider Information

NPI Number : 1700253663
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALYSSA KAYE CARLSON
Provider Business Mailing Address
First Line : 34626 SE SWENSON DR
Second Line : APT. C101
City : SNOQUALMIE
State : WA
Zip : 98065-5107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 209 MAIN AVE S
Second Line :
City : NORTH BEND
State : WA
Zip : 98045-8139
Country : US
Telephone Number : 425-888-3347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2015
Last Update Date : 08/26/2015

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Directions to “ MRS. ALYSSA KAYE CARLSON ” Practice Location

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