Provider Demographics
NPI:1831369248
Name:ALLEY, EDWARD GARTH (MA)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:GARTH
Last Name:ALLEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WALL ST APT 226
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1541
Mailing Address - Country:US
Mailing Address - Phone:206-356-7513
Mailing Address - Fax:
Practice Address - Street 1:500 WALL ST APT 226
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1541
Practice Address - Country:US
Practice Address - Phone:206-356-7513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health