Provider Demographics
NPI:1497103394
Name:MILLAGE-FOX, ALEXA MICHELLE (CNA)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:MICHELLE
Last Name:MILLAGE-FOX
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11510 NE 112TH DR APT 70
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3292
Mailing Address - Country:US
Mailing Address - Phone:360-947-6318
Mailing Address - Fax:
Practice Address - Street 1:11510 NE 112TH DR APT 70
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-3292
Practice Address - Country:US
Practice Address - Phone:360-947-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide