Provider Demographics
NPI:1689757874
Name:ALEXANDER, WENDI DIANE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:WENDI
Middle Name:DIANE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:WENDI
Other - Middle Name:DIANE
Other - Last Name:BUELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:330 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1642
Practice Address - Country:US
Practice Address - Phone:360-435-2133
Practice Address - Fax:360-435-1415
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007524363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3946ALOtherBSWA
605960012OtherUSDLAB
WA0219012OtherLIWA
WA9650995Medicaid
WA9650995Medicaid
WA3946ALOtherBSWA
605960012OtherUSDLAB