Provider Demographics
NPI:1316069552
Name:REYNOLDS, ALEXY KATHLEEN (LMT)
Entity type:Individual
Prefix:
First Name:ALEXY
Middle Name:KATHLEEN
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S SAMPSON ST
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3811
Mailing Address - Country:US
Mailing Address - Phone:509-968-6659
Mailing Address - Fax:509-962-2270
Practice Address - Street 1:109 S WATER ST STE 2
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3061
Practice Address - Country:US
Practice Address - Phone:509-968-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011570175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath