Healthcare Provider Details

I. General information

NPI: 1659811610
Provider Name (Legal Business Name): ALEXANDRA YURY PLYASOVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-4423
US

IV. Provider business mailing address

16916 140TH AVE NE STE 300
WOODINVILLE WA
98072-6957
US

V. Phone/Fax

Practice location:
  • Phone: 206-520-5000
  • Fax:
Mailing address:
  • Phone: 425-481-6363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT6676
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD61043321
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: