Individual
MS. ALICE RENEE LOEBSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
5000 ABBEY WAY SE, LACEY, WA 98503
(360) 438-4536
(360) 438-4568
Mailing address
5000 ABBEY WAY SE, LACEY, WA 98503-3200
(253) 363-0005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A160095964
WA DEPARTMENT OF HEALTH LISCENSE
WA
Enumeration date
02/09/2007
Last updated
08/20/2018
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