Healthcare Provider Details

I. General information

NPI: 1689202400
Provider Name (Legal Business Name): ALEXANDRA PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17707 W MAIN ST FL 1
MONROE WA
98272-1967
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 360-282-3885
  • Fax: 360-512-2026
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.MD.61432838
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: