Healthcare Provider Details

I. General information

NPI: 1700472883
Provider Name (Legal Business Name): ALEXIA NICOLE CAESAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 111TH AVE NE APT 210
BELLEVUE WA
98004-5161
US

IV. Provider business mailing address

288 111TH AVE NE APT 210
BELLEVUE WA
98004-5161
US

V. Phone/Fax

Practice location:
  • Phone: 559-312-8312
  • Fax:
Mailing address:
  • Phone: 559-312-8312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: