Provider Demographics
NPI:1588326110
Name:WELLER, ALYSSA (LMFT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:WELLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:WALLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4805 BRISTOL WAY
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908
Mailing Address - Country:US
Mailing Address - Phone:509-741-9343
Mailing Address - Fax:
Practice Address - Street 1:120 S. 3RD ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901
Practice Address - Country:US
Practice Address - Phone:509-248-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61404353106H00000X
101YM0800X
WALF61551802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health