Provider Demographics
NPI:1326386087
Name:ALEXANDRA DEMETRO, ND
Entity Type:Organization
Organization Name:ALEXANDRA DEMETRO, ND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:N.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:DEMETRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-687-0800
Mailing Address - Street 1:408 E. MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9999
Mailing Address - Country:US
Mailing Address - Phone:360-687-0800
Mailing Address - Fax:360-687-1600
Practice Address - Street 1:408 E MAIN ST
Practice Address - Street 2:BATTLE GROUND HEALING ARTS
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604
Practice Address - Country:US
Practice Address - Phone:360-687-0800
Practice Address - Fax:360-687-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60254488175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty