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Individual

DR. STACY MARIE TARANGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-3131
Mailing address
P.O. BOX 24783, SEATTLE, WA 98124-0783
(405) 682-3303

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A105731
CA
208000000X
Pediatrics Physician
Primary
MD60558747
WA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD60558747
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508018110
WA
Enumeration date
10/14/2008
Last updated
09/23/2015
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