Individual
MRS. KATHLEEN A STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1655 S MARKET BLVD STE B, CHEHALIS, WA 98532-3826
(866) 599-3376
(503) 362-8435
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10005300
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2034282
—
WA
05
—
8498446
—
WA
Enumeration date
08/24/2007
Last updated
09/01/2020
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