Provider Demographics
NPI:1548656317
Name:TAO, ALEXANDER (LAC, LMP)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:TAO
Suffix:
Gender:M
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4118 94TH PL SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4255
Mailing Address - Country:US
Mailing Address - Phone:206-818-1621
Mailing Address - Fax:
Practice Address - Street 1:509 OLIVE WAY STE 1315
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1771
Practice Address - Country:US
Practice Address - Phone:206-382-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60507214225700000X
WAAC 60704819171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist