Basic Information
| Provider Information | |||||||||
| NPI: | 1154916435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHARDING-WILCOX | ||||||||
| FirstName: | ALEXANDER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11019 NE SKIDMORE ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972202465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2623091644 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6221 NE FOURTH PLAIN BLVD APT 130 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986617210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608310908 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2021 | ||||||||
| LastUpdateDate: | 03/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CG61148426 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.