Most Relevant Information
Provider Data
| NPI Number: | 1003208612 |
| Provider Name: | ALEXANDRA CORNWALL PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/19/2015 |
| Last Updated: | 04/05/2021 |
Provider Practice Location
209 MARTIN LUTHER KING JR WAY
TACOMA
WA
984054265
Practice Location Phone/Fax
| Phone: | 2535963300 |
| Fax: |
Provider Mailing Location
209 MARTIN LUTHER KING JR WAY
TACOMA
WA
984054265
Provider Mailing Phone/Fax
| Phone: | 2535963300 |
| Fax: |