Provider Demographics
NPI:1568685642
Name:SOLLEK, ALEXANDRA O (LMP, LAC)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:O
Last Name:SOLLEK
Suffix:
Gender:F
Credentials:LMP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 HARRIS PL S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5924
Mailing Address - Country:US
Mailing Address - Phone:206-291-2810
Mailing Address - Fax:
Practice Address - Street 1:704 WARREN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4027
Practice Address - Country:US
Practice Address - Phone:206-291-2810
Practice Address - Fax:206-400-7911
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017680174400000X
WAAC6006789171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist