Individual
DR. DIANE R STAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2510 SULWHANON DR, EVERSON, WA 98247-9749
(360) 966-2106
(360) 966-2304
Mailing address
PO BOX 157, DEMING, WA 98244-0157
(360) 733-4229
(360) 733-7928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00038077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669521704
NPI
WA
05
—
8268518
—
WA
Enumeration date
01/09/2007
Last updated
04/29/2013
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