Provider Demographics
NPI:1730578659
Name:HALLE, ALEXIA STEPHANIE
Entity type:Individual
Prefix:MS
First Name:ALEXIA
Middle Name:STEPHANIE
Last Name:HALLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALEXIA
Other - Middle Name:STEPHANIE
Other - Last Name:COROTAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0098
Mailing Address - Country:US
Mailing Address - Phone:425-385-5250
Mailing Address - Fax:
Practice Address - Street 1:8702 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2040
Practice Address - Country:US
Practice Address - Phone:425-385-5250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00164796163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool