Provider Demographics
NPI:1437603065
Name:QUINN, ALEXANDRA HAYLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:HAYLEY
Last Name:QUINN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:4744 41ST AVE SW
Practice Address - Street 2:SUITE 101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4570
Practice Address - Country:US
Practice Address - Phone:206-320-5780
Practice Address - Fax:206-320-5794
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60642856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical