Provider Demographics
NPI:1053715169
Name:HALVERSON, ALISHA COLLEEN (DNP, CNM, ARNP)
Entity type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:COLLEEN
Last Name:HALVERSON
Suffix:
Gender:F
Credentials:DNP, CNM, ARNP
Other - Prefix:DR
Other - First Name:ALISHA
Other - Middle Name:HALVERSON
Other - Last Name:WILKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP,CNM,ARNP
Mailing Address - Street 1:521 BULLFROG RD
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8276
Mailing Address - Country:US
Mailing Address - Phone:425-891-2914
Mailing Address - Fax:
Practice Address - Street 1:4300 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:425-207-8769
Practice Address - Fax:833-434-1353
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60515716363LW0102X, 363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology