Healthcare Provider Details

I. General information

NPI: 1255727772
Provider Name (Legal Business Name): ALEXANDER JAMES KULA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE OC.7.830
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SAND POINT WAY NE OC.7.830
SEATTLE WA
98105
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberML60567558
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: