MEDICARE: ALEXIS ROSSI

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

General Provider Information

NPI Number	:	1720552888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS ROSSI

Provider Business Mailing Address
First Line	:	1633 MARSHALL AVE
Second Line	:
City	:	ENUMCLAW
State	:	WA
Zip	:	98022-3108
Country	:	US
Telephone Number	:	253-951-5423
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 MARSHALL AVE
Second Line	:
City	:	ENUMCLAW
State	:	WA
Zip	:	98022-3108
Country	:	US
Telephone Number	:	253-951-5423
Fax Number	:

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

Provider Enumeration Date	:	01/11/2019
Last Update Date	:	01/11/2019

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Directions to “ ALEXIS ROSSI ” Practice Location

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