Individual
BRENDA LEE ANITA MARIE STAVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN MSN ARNP
Contact information
Practice address
16233 SYLVESTER RD SW, SUITE G40, BURIEN, WA 98166-3045
(206) 244-6625
(206) 244-6726
Mailing address
2916 N 32ND ST, TACOMA, WA 98407-6436
(206) 890-8074
(206) 244-6726
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP30007442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219212
L&I
WA
05
—
1669571394
—
WA
Enumeration date
09/21/2006
Last updated
03/10/2020
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