Provider Demographics
NPI:1578008496
Name:THOMAS, ALEXIS SHYANN
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SHYANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 LINDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8820
Mailing Address - Country:US
Mailing Address - Phone:425-583-8738
Mailing Address - Fax:
Practice Address - Street 1:10716 LINDEN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8820
Practice Address - Country:US
Practice Address - Phone:425-583-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-01
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician