Provider Demographics
NPI:1790392421
Name:PIZZO, ALEXANDRA GRACE
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:GRACE
Last Name:PIZZO
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 1:760 NW 185TH AVE UNIT 203
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2892
Mailing Address - Country:US
Mailing Address - Phone:503-380-9629
Mailing Address - Fax:
Practice Address - Street 1:6310 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-6891
Practice Address - Country:US
Practice Address - Phone:971-940-1980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health