Provider Demographics
NPI:1063882587
Name:YOUNG, ALEXANDRA JORDAN (RN)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:JORDAN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 W MUKILTEO BLVD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-1519
Mailing Address - Country:US
Mailing Address - Phone:425-773-6268
Mailing Address - Fax:
Practice Address - Street 1:2129 W MUKILTEO BLVD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-1519
Practice Address - Country:US
Practice Address - Phone:425-773-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 60568907163W00000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse