Provider Demographics
NPI:1588381578
Name:TIPPIT, ALEXA LEE (LMT)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:LEE
Last Name:TIPPIT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:LEE
Other - Last Name:TIPPIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:17423 73RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8192
Mailing Address - Country:US
Mailing Address - Phone:503-713-8287
Mailing Address - Fax:
Practice Address - Street 1:17432 SMOKEY POINT BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8784
Practice Address - Country:US
Practice Address - Phone:360-653-2222
Practice Address - Fax:360-653-5730
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61369543225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist