Basic Information
Provider Information
NPI: 1992161657
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERREE
FirstName: ALICE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MADIGAN ARMY MEDICAL CTR
Address2: 9040 REID STREET, ATTN: MCHJ-CLQ-C
City: TACOMA
State: WA
PostalCode: 984311100
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Practice Location
Address1: MADIGAN ARMY MEDICAL CTR
Address2: 9040 REID STREET, ATTN: MCHJ-CLQ-C
City: TACOMA
State: WA
PostalCode: 984311100
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Other Information
ProviderEnumerationDate: 01/12/2016
LastUpdateDate: 01/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X149.017772ILY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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