Philip M. Alex, PH.D.

Individual provider Active NPI Psychologist · Mill Creek, WA

NPI 1902961345 · NPPES record last updated Dec 9, 2022

Key facts

NPI
1902961345
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
PSY12556 (CA)
Practice address
14502 21St CT SE
Mill Creek, WA 98012-5785
Phone
(415) 457-6234
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Opted out of Medicare
Yes, effective Jul 1, 2015 through Jul 1, 2027

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12556CAMDPsychologist
12556CAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12556 CA Yes

Addresses

Primary practice location

14502 21St CT SE
Mill Creek, WA 98012-5785

Mailing address

15833 Mill Creek Blvd., #14187
Mill Creek, WA 98082
Phone (415) 457-6234

Other providers in Mill Creek, WA

All providers in Mill Creek, WA · Psychologist in Washington

Sources for this page

Verify at the official NPI Registry.