Provider Demographics
NPI:1538387915
Name:WASHLAKE, ALYSSA ANN (NP)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:ANN
Last Name:WASHLAKE
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Gender:F
Credentials:NP
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Mailing Address - Street 1:3701 SKYPARK DR
Mailing Address - Street 2:STE 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4753
Mailing Address - Country:US
Mailing Address - Phone:310-378-8900
Mailing Address - Fax:310-791-0789
Practice Address - Street 1:3701 SKYPARK DRIVE
Practice Address - Street 2:STE 200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-378-8900
Practice Address - Fax:310-791-0789
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-09-13
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Provider Licenses
StateLicense IDTaxonomies
CANP15047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner