Basic Information
| Provider Information | |||||||||
| NPI: | 1295002426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARLSON | ||||||||
| FirstName: | ALEXIS | ||||||||
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| Credential: | LMP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 140TH AVE NE | ||||||||
| Address2: | STE D | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980052972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256880223 | ||||||||
| FaxNumber: | 4256880323 | ||||||||
| Practice Location | |||||||||
| Address1: | 1050 140TH AVE NE | ||||||||
| Address2: | STE D | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980052972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256880223 | ||||||||
| FaxNumber: | 4256880323 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2011 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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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 | 225700000X | MA 60254054 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.