Individual
STEFANIE A HLASTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-2000
Mailing address
4500 SAND POINT WAY NE, #100, SEATTLE, WA 98105-3900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY00003093
WA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY00003093
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000728
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8410060
—
WA
Enumeration date
10/13/2006
Last updated
02/05/2009
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