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General NPI Number Information
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NPI Number | 1629785092
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Entity Type | Individual
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Provider Name | ALEXANDRA WHITE AUD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 913 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-6523
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Country | US
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Telephone | 541-440-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 138 NW PAWNEE CT
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City | ROSEBURG
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State | OR
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Zip | 97471-1242
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Country | US
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Telephone | 386-235-4349
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 31044
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License Number State | OR
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