Healthcare Provider Details

I. General information

NPI: 1205767183
Provider Name (Legal Business Name): ALEXIS WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E COLFAX AVE
BENNETT CO
80102-8825
US

IV. Provider business mailing address

18231 COTTONWOOD DR APT 307
PARKER CO
80138-8935
US

V. Phone/Fax

Practice location:
  • Phone: 303-558-1048
  • Fax:
Mailing address:
  • Phone: 303-747-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00206693
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: