Provider Demographics
NPI:1578037065
Name:RABERN, ALEX (LMFT)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:RABERN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:VIOLET
Other - Middle Name:
Other - Last Name:RABERN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18252 132ND PL NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-5727
Mailing Address - Country:US
Mailing Address - Phone:425-465-4016
Mailing Address - Fax:
Practice Address - Street 1:18252 132ND PL NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-5727
Practice Address - Country:US
Practice Address - Phone:425-465-4016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61398186106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist