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General NPI Number Information
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NPI Number | 1649913823
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Entity Type | Individual
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Provider Name | ALEXANDRA NEENAN PHD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 26401 PACIFIC HWY S STE 101
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City | DES MOINES
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State | WA
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Zip | 98198-9247
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Country | US
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Telephone | 206-870-3590
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Fax | 206-824-1670
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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 | 425-277-1566
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MC61429743
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 21254020901
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY61617210
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License Number State | WA
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