Basic Information
| Provider Information | |||||||||
| NPI: | 1952716607 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NOWLIN | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | HARTWELL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | NOWLIN | ||||||||
| OtherFirstName: | ALEX | ||||||||
| OtherMiddleName: | HARTWELL | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4029 NORTHWEST AVE STE 301 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982269077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607520518 | ||||||||
| FaxNumber: | 3606762896 | ||||||||
| Practice Location | |||||||||
| Address1: | 4029 NORTHWEST AVE STE 301 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982269077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607520518 | ||||||||
| FaxNumber: | 3606762896 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2014 | ||||||||
| LastUpdateDate: | 04/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | MD60935582 | WA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 207R00000X | 260738 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | MD60935582 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | MD60935582 | 01 | WA | STATE OF WASHINGTON | OTHER |