Provider Demographics
NPI:1801492004
Name:BRAUN, ALEXANDRA THERESE EMIKO (LPO, CPO)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:THERESE EMIKO
Last Name:BRAUN
Suffix:
Gender:F
Credentials:LPO, CPO
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:EMIKO
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 E JEFFERSON ST STE 402
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5643
Mailing Address - Country:US
Mailing Address - Phone:206-241-2786
Mailing Address - Fax:
Practice Address - Street 1:1600 E JEFFERSON ST STE 402
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5643
Practice Address - Country:US
Practice Address - Phone:206-241-2786
Practice Address - Fax:206-241-3349
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPS61081423224P00000X
WAOI61147080222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty