Provider Demographics
NPI:1861820078
Name:ALEXANDER ENTERPRISES, LLC
Entity type:Organization
Organization Name:ALEXANDER ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIGIT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-948-7856
Mailing Address - Street 1:15021 MAIN ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1651
Mailing Address - Country:US
Mailing Address - Phone:425-948-7856
Mailing Address - Fax:
Practice Address - Street 1:15021 MAIN ST
Practice Address - Street 2:SUITE K
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1651
Practice Address - Country:US
Practice Address - Phone:425-948-7856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEXANDER ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014715305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization