Individual
DEBRA JO STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3950 BIRCH ST, WASHOUGAL, WA 98671-8912
(360) 931-6620
Mailing address
3950 BIRCH ST, WASHOUGAL, WA 98671-8912
(360) 931-6620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60138699
WA
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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