MEDICARE: DR. ALEXANDER TAN N.D.

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	175F00000X	Naturopath	212	CA
2	175F00000X	Naturopath	NT00001528	WA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61279914	WA

General Provider Information

NPI Number	:	1306992698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER TAN N.D.

Provider Business Mailing Address
First Line	:	1455 NW LEARY WAY STE 400
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5138
Country	:	US
Telephone Number	:	206-880-0611
Fax Number	:	206-672-3366

Provider Business Practice Location Address
First Line	:	1455 NW LEARY WAY STE 400
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5138
Country	:	US
Telephone Number	:	206-880-0611
Fax Number	:	206-672-3366

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

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	02/02/2025

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