Provider Demographics
NPI:1447499801
Name:ALEXANDER, GARY D (MS, MFT)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:D
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6523 CALIFORNIA AVE SW STE 132
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1833
Mailing Address - Country:US
Mailing Address - Phone:360-836-4298
Mailing Address - Fax:
Practice Address - Street 1:3213 HARBOR AVE SW STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4600
Practice Address - Country:US
Practice Address - Phone:360-836-4298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1329106H00000X
NV1020106H00000X
WALF61159909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist