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General NPI Number Information
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NPI Number | 1013055995
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Entity Type | Individual
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Provider Name | MARI KRESGE ALEXANDER PA-C, LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 226 SE 8TH AVE
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City | HILLSBORO
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State | OR
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Zip | 97123-4218
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Country | US
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Telephone | 503-601-7400
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Fax | 503-601-7311
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | CORNELIUS
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State | OR
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Zip | 97113-0568
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Country | US
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Telephone | 503-352-8657
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Fax | 503-352-8658
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0523
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01219
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License Number State | OR
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