Individual
ALEXANDRIA DEATHERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8815 S TACOMA WAY STE 122, LAKEWOOD, WA 98499-7011
(253) 682-0320
Mailing address
22910 SE 281ST PL, MAPLE VALLEY, WA 98038-8135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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