Individual
ALEXANDER A DIVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 SOUTH J STREET SUITE 336, SOUTH PAVILLION, MS 01-30, TACOMA, WA 98405
(253) 426-6970
(253) 426-6936
Mailing address
1717 S J ST #336, SOUTH PAVILLION, MS 01-30, TACOMA, WA 98405
(253) 426-6970
(253) 426-6936
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD-17653
HI
208M00000X
Hospitalist Physician
Primary
MD60789297
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2011
Last updated
03/30/2021
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