Provider Demographics
NPI:1235892555
Name:COLES, ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:COLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SWAN LOOP
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8819
Mailing Address - Country:US
Mailing Address - Phone:253-227-0986
Mailing Address - Fax:
Practice Address - Street 1:201 160TH ST S STE 301
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8508
Practice Address - Country:US
Practice Address - Phone:253-396-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor