MEDICARE: ALEXA MAGDALENA AYALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		WA

General Provider Information

NPI Number	:	1336967942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA MAGDALENA AYALA

Provider Business Mailing Address
First Line	:	3810 166TH PL NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8402
Country	:	US
Telephone Number	:	425-949-0801
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 166TH PL NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8402
Country	:	US
Telephone Number	:	425-949-0801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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Directions to “ ALEXA MAGDALENA AYALA ” Practice Location

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