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NPI Code Detail

MEDICARE: AUTUMN ALEXANDER

MEDICARE: AUTUMN ALEXANDER
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
1390200000XStudent in an Organized Health Care Education/Training ProgramWA
2175T00000XPeer SpecialistCG61683928WA

General Provider Information

NPI Number : 1598599094
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUTUMN ALEXANDER
Provider Business Mailing Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number :
Provider Business Practice Location Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2024
Last Update Date : 06/10/2026

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Directions to “ AUTUMN ALEXANDER ” Practice Location

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