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Provider Information for 1386986503

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALYSSA K GOMEZ SUDP

Other Name:   ALYSSA BARNES
Gender: FEMALE

Individual NPI: 1386986503

Calendar   Last Updated:  2021-07-26
  Certification Date:  2021-07-26

Details

Name Value
NPI 1386986503
Enumeration Date 2013-03-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 8514 W GAGE BLVD STE G
KENNEWICK, WA 99336-8108
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 8514 W GAGE BLVD STE G
KENNEWICK, WA 99336-8108
United States

Phone: 509-593-5064 | Fax: 888-745-2096
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 101YA0400X - Counselor Addiction (Substance Use Disorder) WA CP60297766