Healthcare Provider Details

I. General information

NPI: 1215277371
Provider Name (Legal Business Name): ALEXANDER MARK SAUER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 4TH PLAIN BLVD BLDG 17 STE B222
VANCOUVER WA
98661-3753
US

IV. Provider business mailing address

PO BOX 1845
VANCOUVER WA
98668-1845
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-8484
  • Fax: 360-397-8494
Mailing address:
  • Phone: 360-397-8484
  • Fax: 360-397-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: