Provider Demographics
NPI:1194156117
Name:NIENHUIS, ALEXANDRA LAUREN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:LAUREN
Last Name:NIENHUIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:LAUREN
Other - Last Name:KINZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5371
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5005
Mailing Address - Country:US
Mailing Address - Phone:206-987-5770
Mailing Address - Fax:206-987-5779
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-01
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60423173363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics