# DR PATRICE N STEVENSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104128727
- **Authorized official:** DR. PATRICE N STEVENSON (PHYSICIAN)
- **Authorized official phone:** (253) 862-5138

## Contact information

- **Practice address:** 407 14TH AVE SE, PUYALLUP, WA 98372-3770
- **Practice address phone:** (253) 862-5138
- **Practice address fax:** (253) 862-5138
- **Mailing address:** 4468 185TH AVE E, LAKE TAPPS, WA 98391-9112
- **Mailing address phone:** (253) 862-5138
- **Mailing address fax:** (253) 862-5138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD00022286 | WA | Yes |

## Other

- **Enumeration date:** 12/02/2010
- **Last updated:** 12/02/2010