Healthcare Provider Details

I. General information

NPI: 1538486139
Provider Name (Legal Business Name): ALEXIS M GRIFFITHS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS LACHAPELLE PT

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SE 192ND AVE SUITE 106
VANCOUVER WA
98683-1442
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 360-553-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60259482
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: