Individual
ALISA FAYE HEMMERSBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5512 ANTON CT SE, OLYMPIA, WA 98501-5104
(360) 584-8138
Mailing address
5512 ANTON CT SE, OLYMPIA, WA 98501-5104
(360) 584-8138
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60822854
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-3403817
IRS
WA
Enumeration date
01/03/2018
Last updated
01/03/2018
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