Healthcare Provider Details

I. General information

NPI: 1649689761
Provider Name (Legal Business Name): MALIA ALEXANDER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALEA ALEXANDER

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15206 10TH AVE SW STE D
BURIEN WA
98166-2107
US

IV. Provider business mailing address

5608 17TH AVE NW STE 1731
SEATTLE WA
98107-5232
US

V. Phone/Fax

Practice location:
  • Phone: 206-558-9808
  • Fax: 206-480-0693
Mailing address:
  • Phone: 206-558-9808
  • Fax: 206-480-0693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60992354
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60775999
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: