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General NPI Number Information
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NPI Number | 1194148270
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Entity Type | Individual
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Provider Name | ALEXIS GERARD KROGH RN
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 12932 NE 147TH PL
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City | WOODINVILLE
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State | WA
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Zip | 98072-4634
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Country | US
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Telephone | 206-954-3455
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Fax |
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Provider Business Mailing Address
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Address Line | 12932 NE 147TH PL
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City | WOODINVILLE
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State | WA
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Zip | 98072-4634
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Country | US
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Telephone | 206-954-3455
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60440829
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 00146204
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License Number State | WA
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