Active NPI
Alissa J Hickerson, L.AC., EAMP
- Acupuncturist
- Seattle, WA
National Provider Identifier
1114542131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC61021576
- Practice address
- 5607 Keystone PL N Ste a
Seattle, WA 98103-5963 - Phone
- (206) 486-5052
- NPI assigned
- Jun 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC61021576 | WA | Primary |
Addresses
Primary practice location
5607 Keystone PL N Ste a
Seattle, WA 98103-5963
Mailing address
717 N 115TH St
Seattle, WA 98133-8206
Phone (206) 486-5052
Other practice location 1
5512 Roosevelt Way NE
Seattle, WA 98105-3631
Phone (206) 486-5052
Other practice location 2
120 1st Ave NW
Issaquah, WA 98027-3228
Phone (425) 557-9519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC61021576 | WA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christina Jackson L.Ac. and Associates | Acupuncturist | Past | Accepting new patients |
| Integral Medicine PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Acupuncturist
- Tacoma, WA
- NPI 1467685768
-
- Family Medicine Physician
- Issaquah, WA
- NPI 1316355183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1114542131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 N 115TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981338206",
"telephone_number": "206-486-5052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5607 KEYSTONE PL N STE A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981035963",
"telephone_number": "206-486-5052"
}
],
"practiceLocations": [
{
"address_1": "5512 Roosevelt Way NE",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981053631",
"country_code": "US",
"telephone_number": "206-486-5052",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "120 1st Ave NW",
"address_purpose": "LOCATION",
"city": "Issaquah",
"state": "WA",
"postal_code": "980273228",
"country_code": "US",
"telephone_number": "425-557-9519",
"fax_number": "425-557-0595",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKERSON",
"first_name": "ALISSA",
"middle_name": "J",
"credential": "L.AC., EAMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-15",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WA",
"license": "AC61021576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.