Healthcare Provider Details

I. General information

NPI: 1508760901
Provider Name (Legal Business Name): ALEXANDRA ERICA CROSS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 NE HAZEL DELL AVE
VANCOUVER WA
98665-8047
US

IV. Provider business mailing address

5729 NE SIMPSON ST
PORTLAND OR
97218-2357
US

V. Phone/Fax

Practice location:
  • Phone: 360-977-6090
  • Fax:
Mailing address:
  • Phone: 831-332-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA70124634
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: