Provider Demographics
NPI:1194272005
Name:GILMORE, ALIYA (BSW)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:
Last Name:GILMORE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18537 68TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-2604
Mailing Address - Country:US
Mailing Address - Phone:206-547-5810
Mailing Address - Fax:206-634-1477
Practice Address - Street 1:18537 68TH AVE NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-2604
Practice Address - Country:US
Practice Address - Phone:206-547-5810
Practice Address - Fax:206-634-1477
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor