DR. ALYSA ANNE POULIN MD, PHD
NPI 1871099945
Student in an Organized Health Care Education/Training Program in Seattle, WA

Q: What is Alysa Poulin's NPI number?

The NPI number for Alysa Poulin is 1871099945. It was assigned to this individual provider in the NPPES registry on April 5, 2018.

Q: What is Alysa Poulin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Alysa Poulin was last updated on August 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 05, 2018PECOS Enrolled

850 REPUBLICAN ST, C-432, SEATTLE, WA 98109(204) 396-7472 Get Directions Write a Review

NPPES record last updated: August 29, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Alysa Anne Poulin Md, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALYSA ANNE POULIN MD, PHD (NPI 1871099945) is an individual student in an organized health care education/training program in Seattle, Washington and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871099945

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. ALYSA ANNE POULINCredential: MD, PHD

Location Address850 REPUBLICAN ST, C-432Seattle, WA 98109-4325

Mailing Address4800 Sandpoint Way Ne, Oc.8.722Seattle, WA 98105 · (206) 987-2577 · Fax (206) 987-3840

Phone(204) 396-7472

Sole ProprietorNo

Enumeration DateApril 5, 2018

Last NPPES UpdateAugust 29, 2018

✔ NPI 1871099945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

850 REPUBLICAN ST, Seattle, WA 98109

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Alysa Anne Poulin Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BRAD PRESTON MOORE

Anesthesiology

850 REPUBLICAN ST, BLDG C-4. BOX 358047. GRADUATE MEDICAL EDUCATION
SEATTLE, WA 98109

King County (206) 543-6806

JULIA ROSE RAMIREZ