Healthcare Provider Details

I. General information

NPI: 1861845406
Provider Name (Legal Business Name): ALEXIS SHAWN CANDELIER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 NE PARKWAY DR STE 215
VANCOUVER WA
98662-6653
US

IV. Provider business mailing address

303 NE 16TH AVE APT 217
PORTLAND OR
97232-3091
US

V. Phone/Fax

Practice location:
  • Phone: 213-550-5294
  • Fax: 360-339-5498
Mailing address:
  • Phone: 213-550-5294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: