Individual
MAGDALENA NATALIA STASIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3240 NE 3RD AVE, CAMAS, WA 98607-2408
(360) 838-2440
(360) 838-2450
Mailing address
3240 NE 3RD AVE, CAMAS, WA 98607-2408
(360) 838-2440
(360) 838-2450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085004164
IL
363A00000X
Physician Assistant
AP60298929
WA
363A00000X
Physician Assistant
Primary
PA60298929
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062597
—
IL
01
—
10019630
BCBS
IL
01
—
103788
HEALTHLINK
—
05
—
2023084
—
WA
01
—
33308
HEALTH ALLIANCE
—
01
—
80077375
MEDICARE RAILROAD
—
Enumeration date
10/10/2011
Last updated
01/18/2019
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