Provider Demographics
NPI:1619089901
Name:GIBLIN, ALEXIA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:A
Last Name:GIBLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 NE 45TH ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4690
Mailing Address - Country:US
Mailing Address - Phone:206-250-0642
Mailing Address - Fax:206-632-7173
Practice Address - Street 1:1107 NE 45TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4690
Practice Address - Country:US
Practice Address - Phone:206-250-0642
Practice Address - Fax:206-632-7173
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003876103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling