Provider Demographics
NPI:1104609437
Name:KLAUDT, ALEXA
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:KLAUDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEXIE
Other - Middle Name:
Other - Last Name:KLAUDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20333 S DANVERS RD
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7277
Mailing Address - Country:US
Mailing Address - Phone:425-590-7913
Mailing Address - Fax:
Practice Address - Street 1:24120 VAN RY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5459
Practice Address - Country:US
Practice Address - Phone:425-412-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician