Active NPI
Alexis Eden Louthan
- Licensed Practical Nurse
- Lacey, WA
National Provider Identifier
1023913910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP70012073
- Practice address
- 614 Malibu Dr SE
Lacey, WA 98503-1366 - Phone
- (970) 620-5593
- NPI assigned
- Oct 10, 2026
- Last updated
- Oct 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP70012073 | WA | Primary |
Addresses
Primary practice location
614 Malibu Dr SE
Lacey, WA 98503-1366
Mailing address
614 Malibu Dr SE
Lacey, WA 98503-1366
Phone (970) 620-5593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791590400000",
"number": "1023913910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 MALIBU DR SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985031366",
"telephone_number": "970-620-5593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 MALIBU DR SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985031366",
"telephone_number": "970-620-5593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOUTHAN",
"first_name": "ALEXIS",
"middle_name": "EDEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-10-10",
"last_updated": "2026-10-10",
"certification_date": "2026-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP70012073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.