Provider Demographics
NPI:1003090341
Name:BROUWER WRIGHT, ALEXANDRA MARIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:MARIA
Last Name:BROUWER WRIGHT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SE 79TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5800
Mailing Address - Country:US
Mailing Address - Phone:206-229-5583
Mailing Address - Fax:206-230-0294
Practice Address - Street 1:3245 FAIRVIEW AVE E
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3053
Practice Address - Country:US
Practice Address - Phone:206-229-5583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist