Basic Information
| Provider Information | |||||||||
| NPI: | 1528729589 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVAREZ SEGURA | ||||||||
| FirstName: | ADILENE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2718 S 258TH ST APT A | ||||||||
| Address2: | |||||||||
| City: | KENT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980325562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2537097146 | ||||||||
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| Practice Location | |||||||||
| Address1: | 723 SW 10TH ST | ||||||||
| Address2: | |||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980575223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064614880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2022 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.