Healthcare Provider Details

I. General information

NPI: 1831271873
Provider Name (Legal Business Name): MICHAEL R ALECKSON BRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A-112-BRC BLIND REHABILITATION CTR AMERICAN LAKE/VAMC
TACOMA WA
98493-0001
US

IV. Provider business mailing address

23515 48TH AVE E BOX 4641
SPANAWAY WA
98387-6136
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8440
  • Fax:
Mailing address:
  • Phone: 235-847-9433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: