Individual
MS. JUDITH E. STACEY-ROBAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1851 CENTRAL PL S, SUITE 123, KENT, WA 98030-7514
(253) 520-3060
(253) 859-0043
Mailing address
10041 SE 220TH ST, KENT, WA 98031-2509
(253) 520-7086
(253) 859-0043
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30006451
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007266542
AETNA
WA
01
—
227130100000
PREMERA BLUE CROSS
WA
01
—
5240ST
REGENCE BLUE SHIELD
WA
01
—
8307-01
PACIFICARE BEHAVIORAL HEA
WA
05
—
9638511
—
WA
Enumeration date
12/30/2006
Last updated
07/08/2007
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