Provider Demographics
NPI:1427011097
Name:ALEXANDER, AMY (LMP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-330-0633
Mailing Address - Fax:425-338-9637
Practice Address - Street 1:1519 132ND ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-7203
Practice Address - Country:US
Practice Address - Phone:425-337-9556
Practice Address - Fax:425-357-9186
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0200796OtherDEPT. OF LABOR & INDUSTRY
WA5029ALOtherREGENCE BLUE SHIELD
WA1170ALOtherREGENCE BLUE SHIELD
WA7058522OtherAETNA
WA8933504OtherL & I CRIME VICTIMS
WA1519ALOtherREGENCE BLUE SHIELD