Provider Demographics
NPI:1821417643
Name:WESTLAKE, ALEXANDRIA A (CNM)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:A
Last Name:WESTLAKE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 W B ST STE O
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-4593
Mailing Address - Country:US
Mailing Address - Phone:458-234-6800
Mailing Address - Fax:
Practice Address - Street 1:188 W B ST STE O
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4593
Practice Address - Country:US
Practice Address - Phone:458-234-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171889367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife