Healthcare Provider Details

I. General information

NPI: 1720608235
Provider Name (Legal Business Name): ALEXANDER JOHN ARNOLD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST, RR650,
SEATTLE WA
98195
US

IV. Provider business mailing address

1959 NE PACIFIC ST, RR650, BOX 356465
SEATTLE WA
98195
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-2340
  • Fax:
Mailing address:
  • Phone: 206-543-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberML61083639
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: