Individual
STACI M HESTDALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1807 N HUTCHINSON RD, SPOKANE VALLEY, WA 99212-2444
(509) 456-7414
(509) 624-0763
Mailing address
1807 N HUTCHINSON RD, SPOKANE VALLEY, WA 99212-2444
(509) 456-7414
(509) 624-0763
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00043715
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8394454
—
WA
Enumeration date
02/22/2006
Last updated
08/13/2019
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