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Individual

ALYSSA ROSE WEBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
57 W MAIN ST, CHEHALIS, WA 98532-4815
(360) 999-8169
Mailing address
PO BOX 57, CENTRALIA, WA 98531-0057
(360) 508-7117

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60520479
WA
376K00000X
Nurse's Aide
NC10097214
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CG60520479
AGENCY AFFILIATED COUNSELOR
WA
01
NC10097214
NURSING ASSISTANT CERTIFICATION
WA
Enumeration date
11/08/2017
Last updated
03/17/2018
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