Provider Demographics
NPI:1437426970
Name:DEGROOT, ALEXANDRA L (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:L
Last Name:DEGROOT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:L
Other - Last Name:DYKHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:1231 116TH AVE NE
Practice Address - Street 2:SUITE 915
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3804
Practice Address - Country:US
Practice Address - Phone:425-454-3938
Practice Address - Fax:425-454-2568
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1713231H00000X
WALD60411055231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist