# STACEY D WATSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184762130
- **Gender:** F
- **Credential:** MS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | LD 00002570 | WA | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 04/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0039572 | LABOR AND INDUSTRIES\# | WA |
| 01 | — | 4477WA | BLUE SHIELD\# | WA |
| 01 | — | 640004238 | RAILROAD MC\# | WA |
| 05 | — | 8368235 | — | WA |
| 01 | — | US2498706 | AETNA SPECIALIST PIN | WA |