Active NPI
Alyssa Rose Weber
- Counselor
- Chehalis, WA
National Provider Identifier
1669985990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60520479
- Practice address
- 57 W Main St
Chehalis, WA 98532-4815 - Phone
- (360) 999-8169
- NPI assigned
- Nov 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | NC10097214 | WA | |
| Counselor | 101Y00000X | CG60520479 | WA | Primary |
Addresses
Primary practice location
57 W Main St
Chehalis, WA 98532-4815
Mailing address
PO Box 57
Centralia, WA 98531-0057
Phone (360) 508-7117
Other practice location 1
2512 W Reynolds Ave
Centralia, WA 98531-4556
Phone (360) 736-1064
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG60520479 | Other | WA | AGENCY AFFILIATED COUNSELOR |
| NC10097214 | Other | WA | NURSING ASSISTANT CERTIFICATION |
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 |
|---|---|---|---|
| CG60520479 | WA | MD | Counselor |
| NC10097214 | WA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1669985990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 57",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985310057",
"telephone_number": "360-508-7117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 W MAIN ST",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985324815",
"telephone_number": "360-999-8169"
}
],
"practiceLocations": [
{
"address_1": "2512 W Reynolds Ave",
"address_purpose": "LOCATION",
"city": "Centralia",
"state": "WA",
"postal_code": "985314556",
"country_code": "US",
"telephone_number": "360-736-1064",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEBER",
"first_name": "ALYSSA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "WA",
"license": "NC10097214",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60520479",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY AFFILIATED COUNSELOR",
"identifier": "CG60520479",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING ASSISTANT CERTIFICATION",
"identifier": "NC10097214",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.