Provider Demographics
NPI:1972939403
Name:EBY, ALLISON (CCC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:EBY
Suffix:
Gender:F
Credentials:CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SAND POINT WAY NE
Mailing Address - Street 2:APT. 307
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6200 SAND POINT WAY NE
Practice Address - Street 2:APT. 307
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7970
Practice Address - Country:US
Practice Address - Phone:713-829-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60389526103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst