Basic Information
Provider Information
NPI: 1528039989
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: READ
FirstName: ALEXANDRA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34888
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241888
CountryCode: US
TelephoneNumber: 4259774620
FaxNumber: 4257459836
Practice Location
Address1: 11027 MERIDIAN AVE N
Address2: SUITE 100
City: SEATTLE
State: WA
PostalCode: 981331705
CountryCode: US
TelephoneNumber: 2063654492
FaxNumber: 2063683456
Other Information
ProviderEnumerationDate: 02/01/2006
LastUpdateDate: 03/25/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XMD00028599WAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
101247805WA MEDICAID
010171701WALABOR AND INDUSTRIESOTHER


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