Provider Demographics
NPI:1215746748
Name:NGO, ASHLEY ALEXIS
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ALEXIS
Last Name:NGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 184TH ST SW UNIT D328
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4995
Mailing Address - Country:US
Mailing Address - Phone:253-232-8017
Mailing Address - Fax:
Practice Address - Street 1:23222 E ECHO LAKE RD
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-6813
Practice Address - Country:US
Practice Address - Phone:360-209-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC61487196224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant