Provider Demographics
NPI:1699801886
Name:GELT, ALEXANDRA (OD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:GELT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SW 43RD ST
Mailing Address - Street 2:STE K PMB #163
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4944
Mailing Address - Country:US
Mailing Address - Phone:425-251-9200
Mailing Address - Fax:425-251-9201
Practice Address - Street 1:8009 S 180TH ST STE 104
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-1042
Practice Address - Country:US
Practice Address - Phone:425-251-9200
Practice Address - Fax:425-251-9201
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003405152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5656704OtherAETNA
WA226816OtherLABOR & INDUSTRY
WA1855919OtherUNITED HEALTHCARE
WAP00022814OtherMEDICARE RAILROAD
WA0227GEOtherREGENCE
WAP00022814OtherMEDICARE RAILROAD
WA1855919OtherUNITED HEALTHCARE