MEDICARE: BARBARA JEAN ALEXANDER LMP

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	174400000X	Specialist	MA00004665	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00004665	OTHER	WA	MASSAGE LICENSE

General Provider Information

NPI Number	:	1356565931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JEAN ALEXANDER LMP

Provider Business Mailing Address
First Line	:	40 LAKE BELLEVUE DR STE 220
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2480
Country	:	US
Telephone Number	:	206-499-7793
Fax Number	:	206-783-4522

Provider Business Practice Location Address
First Line	:	40 LAKE BELLEVUE DR STE 220
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2480
Country	:	US
Telephone Number	:	206-499-7793
Fax Number	:	206-783-4522

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	08/29/2019

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