Individual
MRS. STACEY LYNN WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPAS, PA-C
Contact information
Practice address
1730 MINOR AVE STE 1000, SEATTLE, WA 98101-1464
(206) 267-2100
(206) 267-2100
Mailing address
700 S 320TH ST, STE A, FEDERAL WAY, WA 98003-4691
(866) 599-3376
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60118131
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808500600
—
ID
Enumeration date
10/12/2009
Last updated
01/23/2020
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