Basic Information
| Provider Information | |||||||||
| NPI: | 1114400223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAYMOND | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | |||||||||
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| Credential: | BA, CAA, MA-INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29307 45TH PL S | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980011521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533326976 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3808 S ANGELINE ST | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981181712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064614880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2018 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.