Healthcare Provider Details

I. General information

NPI: 1306992698
Provider Name (Legal Business Name): ALEXANDER TAN N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 02/02/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 NW LEARY WAY STE 400
SEATTLE WA
98107-5138
US

IV. Provider business mailing address

1455 NW LEARY WAY STE 400
SEATTLE WA
98107-5138
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-0611
  • Fax: 206-672-3366
Mailing address:
  • Phone: 206-880-0611
  • Fax: 206-672-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61279914
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number212
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001528
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: