Provider Demographics
NPI:1851136741
Name:EWELL, ALYSSA JOY (CF- SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JOY
Last Name:EWELL
Suffix:
Gender:F
Credentials:CF- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 NW GILMAN BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5328
Mailing Address - Country:US
Mailing Address - Phone:425-392-2346
Mailing Address - Fax:
Practice Address - Street 1:1495 NW GILMAN BLVD STE 4
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5328
Practice Address - Country:US
Practice Address - Phone:425-392-2346
Practice Address - Fax:425-392-0185
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61556200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist