Provider Demographics
NPI:1881034007
Name:HALLING, ALEXA (MS, RD)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:HALLING
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16014 70TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-6903
Mailing Address - Country:US
Mailing Address - Phone:818-606-0966
Mailing Address - Fax:
Practice Address - Street 1:16014 70TH AVE NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6903
Practice Address - Country:US
Practice Address - Phone:818-606-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86008550133V00000X
WADI60401444133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered