Individual
STEPHANIE SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7604 NE 176TH AVE, VANCOUVER, WA 98682-2371
(503) 989-7005
Mailing address
7604 NE 176TH AVE, VANCOUVER, WA 98682-2371
(503) 989-7005
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
RN60939398
WA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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