Individual
JENNIFER STAMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4245 ROOSEVELT WAY NE, SEATTLE, WA 98105-6008
(206) 598-4288
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60909537
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114455888
—
WA
Enumeration date
05/25/2017
Last updated
03/01/2019
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