Provider Demographics
NPI:1336175033
Name:DAVID, ALEXIS R (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:R
Last Name:DAVID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:R
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1750 112TH AVE NE STE E168
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3727
Mailing Address - Country:US
Mailing Address - Phone:425-362-6184
Mailing Address - Fax:425-362-6183
Practice Address - Street 1:1750 112TH AVE NE STE E168
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3727
Practice Address - Country:US
Practice Address - Phone:425-362-6184
Practice Address - Fax:425-362-6183
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046572207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I46459Medicare UPIN