MEDICARE: ALESYA RADOSTEVA PSY.D.

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	103T00000X	Psychologist	PY.60924322	WA

General Provider Information

NPI Number	:	1902274475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALESYA RADOSTEVA PSY.D.

Provider Business Mailing Address
First Line	:	636 LAKE WASHINGTON BLVD E STE 103
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	636 LAKE WASHINGTON BLVD E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4229
Country	:	US
Telephone Number	:	206-531-6613
Fax Number	:

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

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	10/30/2025

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