Healthcare Provider Details

I. General information

NPI: 1669319760
Provider Name (Legal Business Name): ALEXONDRIA ELIZABETH FAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PBS, 205 E SPOKANE FALLS BLVD
SPOKANE WA
99202
US

IV. Provider business mailing address

8105 N MEGHAN ST
SPOKANE WA
99208-8984
US

V. Phone/Fax

Practice location:
  • Phone: 757-639-6632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberIR61571722
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: