Provider Demographics
NPI:1275766735
Name:ALEXANDER, COLE (DAOM, EAMP, LAC)
Entity Type:Individual
Prefix:DR
First Name:COLE
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DAOM, EAMP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6128 96TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2428
Mailing Address - Country:US
Mailing Address - Phone:425-419-7033
Mailing Address - Fax:
Practice Address - Street 1:6128 96TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2428
Practice Address - Country:US
Practice Address - Phone:425-419-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14600171100000X
WAAC 60172364171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist