Healthcare Provider Details

I. General information

NPI: 1497601413
Provider Name (Legal Business Name): ALEXIS RAE ALDRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16201 E INDIANA AVE STE 3400
SPOKANE VALLEY WA
99216-2830
US

IV. Provider business mailing address

2406 N PINES RD APT 14
SPOKANE VALLEY WA
99206-7642
US

V. Phone/Fax

Practice location:
  • Phone: 509-900-3669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB70107721
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: