Provider Demographics
NPI:1326772302
Name:HUTZENBILER, ALEXA (MA)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:HUTZENBILER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 POLK LN APT B
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1453
Mailing Address - Country:US
Mailing Address - Phone:701-805-1735
Mailing Address - Fax:
Practice Address - Street 1:3250 AIRPORT WAY S STE 530
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2111
Practice Address - Country:US
Practice Address - Phone:701-805-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61328661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health