Individual
DR. STEPHANIE R SIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4503 OCEAN BEACH HWY STE 103, LONGVIEW, WA 98632-5055
(360) 636-6111
Mailing address
24312 NE 142ND AVE, BATTLE GROUND, WA 98604-9412
(503) 504-2182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00004012
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031748
—
WA
01
—
WA1073SI
NORTHWEST BENEFIT NETWORK
—
Enumeration date
06/19/2006
Last updated
07/08/2007
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