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General NPI Number Information
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NPI Number | 1235440330
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Entity Type | Individual
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Provider Name | ALEX JOSEPH KIPP MD, MALS
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Gender | Male
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 11/11/2023
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Provider Practice Location Address
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Address Line | 3915 TALBOT RD S STE 401
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City | RENTON
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State | WA
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Zip | 98055-5738
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Country | US
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Telephone | 425-690-7592
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Fax | 425-690-9414
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Provider Business Mailing Address
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Address Line | 3915 TALBOT RD S STE 401
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City | RENTON
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State | WA
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Zip | 98055-5738
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Country | US
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Telephone | 425-690-7592
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Fax | 425-690-9414
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C170078
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD179582
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60287601
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License Number State | WA
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