Provider Demographics
NPI:1821812892
Name:BROST, LEXIE (HIS)
Entity type:Individual
Prefix:
First Name:LEXIE
Middle Name:
Last Name:BROST
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4213
Mailing Address - Country:US
Mailing Address - Phone:360-708-7621
Mailing Address - Fax:
Practice Address - Street 1:1023 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4213
Practice Address - Country:US
Practice Address - Phone:360-336-2964
Practice Address - Fax:360-336-6190
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60020372237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist