Healthcare Provider Details

I. General information

NPI: 1497677033
Provider Name (Legal Business Name): ALEXANDRA MCBRIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5727 SE 40TH AVE
PORTLAND OR
97202-7511
US

IV. Provider business mailing address

5727 SE 40TH AVE
PORTLAND OR
97202-7511
US

V. Phone/Fax

Practice location:
  • Phone: 415-254-3511
  • Fax:
Mailing address:
  • Phone: 415-254-3511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: