Provider Demographics
NPI:1053742486
Name:ALEXANDER, MORGAN LEE (LMP)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:LEE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MRS
Other - First Name:MORGAN
Other - Middle Name:LEE
Other - Last Name:MACKENROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:5703 GRANDVIEW DR W
Mailing Address - Street 2:UNIT B
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98467-1116
Mailing Address - Country:US
Mailing Address - Phone:253-353-5076
Mailing Address - Fax:
Practice Address - Street 1:5703 GRANDVIEW DR W
Practice Address - Street 2:UNIT B
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-1116
Practice Address - Country:US
Practice Address - Phone:253-353-5076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist