Healthcare Provider Details
I. General information
NPI: 1841854676
Provider Name (Legal Business Name): ALEXA WASH PROCTOR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2019
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4060 E STEVENS WAY
SEATTLE WA
98195-1397
US
IV. Provider business mailing address
PO BOX 50095
SEATTLE WA
98145-5095
US
V. Phone/Fax
- Phone: 206-597-5242
- Fax:
- Phone: 206-520-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95010498 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP61087253 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: