Individual
SHERRY D STOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 298-4521
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 298-4521
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M5696
ID
208D00000X
General Practice Physician
MD00040032
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69378
WA LABOR & INDUSTRIES
WA
05
—
8118655
—
WA
Enumeration date
10/23/2006
Last updated
07/09/2007
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