Provider Demographics
NPI:1215368378
Name:DANIELS, ALEXANDRIA HOPE
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRIA
Middle Name:HOPE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 NW 5TH CT
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-6813
Mailing Address - Country:US
Mailing Address - Phone:360-604-0894
Mailing Address - Fax:
Practice Address - Street 1:7302 NE 18TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7385
Practice Address - Country:US
Practice Address - Phone:360-750-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA6041696225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist