MEDICARE: LAMBORGHINI ALEXIS BAILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	CG60713943	WA
2	104100000X	Social Worker	SC61516995	WA

General Provider Information

NPI Number	:	1083182307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMBORGHINI ALEXIS BAILEY

Provider Business Mailing Address
First Line	:	107 S DIVISION ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-1510
Country	:	US
Telephone Number	:	509-838-4651
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 E 3RD AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99202-2211
Country	:	US
Telephone Number	:	509-838-4651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	12/23/2025

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Directions to “ LAMBORGHINI ALEXIS BAILEY ” Practice Location

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