Provider Demographics
NPI:1013210749
Name:GAYEK, ALEXANDRA (ND)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:GAYEK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:OLGA
Mailing Address - State:WA
Mailing Address - Zip Code:98279-0522
Mailing Address - Country:US
Mailing Address - Phone:360-376-5484
Mailing Address - Fax:
Practice Address - Street 1:6866 OLGA RD
Practice Address - Street 2:
Practice Address - City:OLGA
Practice Address - State:WA
Practice Address - Zip Code:98279
Practice Address - Country:US
Practice Address - Phone:360-376-5484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00000912175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath