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General NPI Number Information
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NPI Number | 1396206421
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Entity Type | Individual
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Provider Name | MR. ALEXANDER IANTO WEST
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 403 E MEEKER ST STE 200
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City | KENT
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State | WA
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Zip | 98030-5904
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Country | US
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Telephone | 253-852-2866
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Fax | 253-852-3102
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Provider Business Mailing Address
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Address Line | 955 POWELL AVE SW
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City | RENTON
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State | WA
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Zip | 98057-2908
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Country | US
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Telephone | 425-277-1311
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Fax | 888-240-5967
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60997726
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY60997726
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License Number State | WA
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