Provider Demographics
NPI:1447953724
Name:DOAN, ALYSSA CHI
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CHI
Last Name:DOAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14277 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4124
Mailing Address - Country:US
Mailing Address - Phone:206-431-9652
Mailing Address - Fax:206-431-0470
Practice Address - Street 1:14277 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4124
Practice Address - Country:US
Practice Address - Phone:206-431-9652
Practice Address - Fax:206-431-0470
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA60689125183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician