Healthcare Provider Details

I. General information

NPI: 1851755573
Provider Name (Legal Business Name): ALEX TOLDI LEGOCKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 LEVIN RD NW STE 101
SILVERDALE WA
98383-7849
US

IV. Provider business mailing address

9800 LEVIN RD NW STE 101
SILVERDALE WA
98383-7849
US

V. Phone/Fax

Practice location:
  • Phone: 360-613-2600
  • Fax:
Mailing address:
  • Phone: 360-613-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD61378389
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: