Organization
STACEY L. HILES, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY L. HILES M.D. (FAMILY PRACTICE PHYSICIAN)
(425) 235-9614
Entity
Organization
Contact information
Practice address
17900 TALBOT RD S, SUITE 101, RENTON, WA 98055-8212
(425) 235-9614
(425) 235-1060
Mailing address
17900 TALBOT RD S, SUITE 101, RENTON, WA 98055-8212
(425) 235-9614
(425) 235-1060
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
60021347
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1126143
—
WA
Enumeration date
09/05/2008
Last updated
12/27/2008
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