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Individual

STEPHEN E POORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4215 49TH AVE NE, TACOMA, WA 98422-2421
(253) 459-7699
Mailing address
4215 49TH AVE NE, TACOMA, WA 98422-2421
(253) 459-7699

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD00035285
WA
207VG0400X
Gynecology Physician
Primary
MD00035285
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039592
LABOR & INDUSTRY
WA
01
160040245
RAILROAD MEDICARE
05
8221533
WA
01
PO7788
BLUE SHIELD
WA
01
US1004480
AETNA/USHC SPECIALIST
WA
Enumeration date
07/13/2006
Last updated
01/10/2020
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