Healthcare Provider Details

I. General information

NPI: 1427011097
Provider Name (Legal Business Name): AMY ALEXANDER LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 132ND ST SE SUITE A
EVERETT WA
98208-7203
US

IV. Provider business mailing address

1519 132ND ST SE SUITE A
EVERETT WA
98208-7203
US

V. Phone/Fax

Practice location:
  • Phone: 425-337-9556
  • Fax: 425-357-9186
Mailing address:
  • Phone: 425-330-0633
  • Fax: 425-338-9637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: