Provider Demographics
NPI:1215039326
Name:AZULAY, ALAN R (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:AZULAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31753 14TH WAY SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023
Mailing Address - Country:US
Mailing Address - Phone:253-839-7637
Mailing Address - Fax:253-839-7637
Practice Address - Street 1:31753 14TH WAY SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023
Practice Address - Country:US
Practice Address - Phone:253-839-7677
Practice Address - Fax:253-839-7637
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY1901103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7074156Medicare ID - Type Unspecified