Provider Demographics
NPI:1306992698
Name:TAN, ALEXANDER (ND)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:TAN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 NW LEARY WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5138
Mailing Address - Country:US
Mailing Address - Phone:206-880-0611
Mailing Address - Fax:206-672-3366
Practice Address - Street 1:1455 NW LEARY WAY STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5138
Practice Address - Country:US
Practice Address - Phone:206-880-0611
Practice Address - Fax:206-672-3366
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA212175F00000X
WANT00001528175F00000X
WAAP61279914363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No175F00000XOther Service ProvidersNaturopath