Healthcare Provider Details

I. General information

NPI: 1588286819
Provider Name (Legal Business Name): ALEXANDER MICHAEL MCKITRICK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34515 9TH AVE S
FEDERAL WAY WA
98003-6761
US

IV. Provider business mailing address

401 TECUMSEH MEADOWS CT
NORMAN OK
73069-8245
US

V. Phone/Fax

Practice location:
  • Phone: 253-733-3969
  • Fax: 253-838-6285
Mailing address:
  • Phone: 405-388-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.OP.70094976
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number7659
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: