Individual
MR. STEPHEN DANA FEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
4703 PACIFIC HWY E, TACOMA, WA 98424-2620
(253) 922-9570
(253) 922-9587
Mailing address
4703 PACIFIC HWY E, TACOMA, WA 98424
(253) 922-9570
(253) 922-9587
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002988
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127506
L & I PIN
WA
Enumeration date
02/01/2007
Last updated
10/18/2012
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