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Individual

DR. STEPHEN CHURCHLEY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7000
Mailing address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00026834
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8310120
WA
01
9161CH
REGENCE BLUE SHIELD RIDER
Enumeration date
03/10/2006
Last updated
07/08/2007
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