Provider Demographics
NPI:1649143462
Name:SKROBKO, ALEX (LMFTA)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SKROBKO
Suffix:
Gender:M
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19906 E GRACE LN
Mailing Address - Street 2:
Mailing Address - City:OTIS ORCHARDS
Mailing Address - State:WA
Mailing Address - Zip Code:99027-9570
Mailing Address - Country:US
Mailing Address - Phone:509-903-6271
Mailing Address - Fax:
Practice Address - Street 1:19906 E GRACE LN
Practice Address - Street 2:
Practice Address - City:OTIS ORCHARDS
Practice Address - State:WA
Practice Address - Zip Code:99027-9570
Practice Address - Country:US
Practice Address - Phone:509-903-6271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMFTA.MG.61679118106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist