MEDICARE: GARY D ALEXANDER MS, MFT

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	106H00000X	Marriage & Family Therapist	T1329	OR
2	106H00000X	Marriage & Family Therapist	1020	NV
3	106H00000X	Marriage & Family Therapist	LF61159909	WA

General Provider Information

NPI Number	:	1447499801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY D ALEXANDER MS, MFT

Provider Business Mailing Address
First Line	:	6523 CALIFORNIA AVE SW STE 132
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1833
Country	:	US
Telephone Number	:	360-836-4298
Fax Number	:

Provider Business Practice Location Address
First Line	:	3213 HARBOR AVE SW STE 1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-4600
Country	:	US
Telephone Number	:	360-836-4298
Fax Number	:

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

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	05/15/2024

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