Provider Demographics
NPI:1902570872
Name:BARKHURST, ALLISON EMILY (SUDPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:EMILY
Last Name:BARKHURST
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9238 SE VIEW PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-8669
Mailing Address - Country:US
Mailing Address - Phone:360-850-3911
Mailing Address - Fax:
Practice Address - Street 1:2475 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2490
Practice Address - Country:US
Practice Address - Phone:360-876-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60889656101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)