Individual
ALIISA BREISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
21907 64TH AVE W, SUITE 200, MOUNTLAKE TERRACE, WA 98043-2200
(425) 640-7009
Mailing address
15229 50TH AVE W, EDMONDS, WA 98026-4412
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60543485
WA
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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