Basic Information
Provider Information
NPI: 1235492596
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABRESCH-MEYER
FirstName: ALLISON
MiddleName: LEA
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 E KINCAID ST
Address2: ATTN: CREDENTIALING
City: MOUNT VERNON
State: WA
PostalCode: 982744127
CountryCode: US
TelephoneNumber: 3604282500
FaxNumber: 3604286485
Practice Location
Address1: 819 S 13TH ST
Address2:  
City: MOUNT VERNON
State: WA
PostalCode: 982744112
CountryCode: US
TelephoneNumber: 3608146230
FaxNumber: 3608146240
Other Information
ProviderEnumerationDate: 06/21/2012
LastUpdateDate: 10/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XPG169071ORN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XOP60660062WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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