Individual
MARILYN V. STUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
240 W FRONT ST STE A, PORT ANGELES, WA 98362-2609
(360) 452-7891
(360) 452-8087
Mailing address
240 W FRONT ST STE A, PORT ANGELES, WA 98362-2609
(360) 452-7891
(360) 452-8087
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110004849
VA
363AM0700X
Medical Physician Assistant
Primary
PA60019499
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8539652
—
WA
Enumeration date
08/02/2006
Last updated
02/03/2016
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