Provider Demographics
NPI:1720548753
Name:ELLIOTT, ALEXIS D (PA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:D
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4700 POINT FOSDICK DR STE 219
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-851-7733
Mailing Address - Fax:253-851-8060
Practice Address - Street 1:3505 NW ANDERSON HILL RD STE 201
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9161
Practice Address - Country:US
Practice Address - Phone:360-698-6859
Practice Address - Fax:360-337-7403
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61592805363A00000X
NVPA2103363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant