Individual
DR. JOHN COOPER STIVELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NORTHWEST KIDNEY CENTERS, 700 BROADWAY, SEATTLE, WA 98122-4302
(206) 292-2771
(206) 860-5821
Mailing address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 731-5939
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD00037713
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8253015
—
WA
Enumeration date
04/12/2007
Last updated
07/08/2007
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