Healthcare Provider Details

I. General information

NPI: 1558441345
Provider Name (Legal Business Name): M PAMELA ALEXANDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUGET SOUND HEALTH CARE SYSTEM AMERICAN LAKE DIVISION
TACOMA WA
98493-5000
US

IV. Provider business mailing address

1536 DIAMOND RD SE
LACEY WA
98503-2994
US

V. Phone/Fax

Practice location:
  • Phone: 180-032-9837
  • Fax:
Mailing address:
  • Phone: 360-491-6347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN00070373
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: