Healthcare Provider Details

I. General information

NPI: 1568928661
Provider Name (Legal Business Name): ALEXIA M KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 KAI ANI LN
KIHEI HI
96753-5804
US

IV. Provider business mailing address

PO BOX 2512
WAILUKU HI
96793-7512
US

V. Phone/Fax

Practice location:
  • Phone: 360-296-5999
  • Fax:
Mailing address:
  • Phone: 360-296-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2849271
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: