Provider Demographics
NPI:1942848668
Name:RIEL, ALEXA LEE (MPA, PA)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:LEE
Last Name:RIEL
Suffix:
Gender:F
Credentials:MPA, PA
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Other - Credentials:
Mailing Address - Street 1:2200 NE NEFF RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4281
Mailing Address - Country:US
Mailing Address - Phone:541-200-6064
Mailing Address - Fax:
Practice Address - Street 1:2200 NE NEFF RD STE 204
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4281
Practice Address - Country:US
Practice Address - Phone:541-200-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2020-07-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant