Provider Demographics
NPI:1750726139
Name:HAYES, ALISON BERNADETTE (MP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:BERNADETTE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 N G ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4628
Mailing Address - Country:US
Mailing Address - Phone:509-995-6804
Mailing Address - Fax:
Practice Address - Street 1:12121 E BROADWAY AVE
Practice Address - Street 2:BUIDING 5B
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4972
Practice Address - Country:US
Practice Address - Phone:509-921-9800
Practice Address - Fax:509-921-9810
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60351601225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist