Organization
DR PATRICE N STEVENSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICE N STEVENSON (PHYSICIAN)
(253) 862-5138
Entity
Organization
Contact information
Practice address
407 14TH AVE SE, PUYALLUP, WA 98372-3770
(253) 862-5138
(253) 862-5138
Mailing address
4468 185TH AVE E, LAKE TAPPS, WA 98391-9112
(253) 862-5138
(253) 862-5138
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00022286
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252586
WA L & I
WA
05
—
1002229
—
WA
01
—
1340ST
WA REGENCE
WA
01
—
4079238
AETNA
WA
Enumeration date
12/02/2010
Last updated
12/02/2010
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