Provider Demographics
NPI:1386925550
Name:ALSON, LAUREL ANNE
Entity type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:ANNE
Last Name:ALSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAUREL
Other - Middle Name:ANNE
Other - Last Name:WALDEN-ALSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASSOCIATES OF SCIENC
Mailing Address - Street 1:8666 VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:MAPLE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98266-8228
Mailing Address - Country:US
Mailing Address - Phone:360-483-6784
Mailing Address - Fax:
Practice Address - Street 1:8666 VALLEY CT
Practice Address - Street 2:
Practice Address - City:MAPLE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98266-8228
Practice Address - Country:US
Practice Address - Phone:360-483-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60239034225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist