Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | MC60868635 | WA |
NPI | 1003381161 |
---|---|
Provider Name | Mrs. Alyssa Michelle Kirkman |
First Address | Seattle, WA 98101-0924 |
Second Address | Seattle, WA 98109-4228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2018 |
Last Update Date | 04/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
604335707 | WASHINGTON SECRETARY OF STATE (01) | WA |
MC6086835 | WASHINGTON DEPARTMENT OF HEALTH (01) |