Basic Information
Provider Information
NPI: 1518346485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: ALICIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 ORONDO AVE STE 1
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988012800
CountryCode: US
TelephoneNumber: 5096643527
FaxNumber: 5096644590
Practice Location
Address1: 600 ORONDO AVE STE 1
Address2:  
City: WENATCHEE
State: WA
PostalCode: 988012800
CountryCode: US
TelephoneNumber: 5096643527
FaxNumber: 5096644590
Other Information
ProviderEnumerationDate: 05/26/2015
LastUpdateDate: 07/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD60839205WAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
209991205WA MEDICAID


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