Individual
MS. BO STANBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1300 S 320TH ST, FEDERAL WAY, WA 98003-5359
(253) 839-6081
Mailing address
1820 147TH AVE SE, BELLEVUE, WA 98007-6824
(206) 790-5429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004331
WA
Other
Enumeration date
07/05/2007
Last updated
12/07/2011
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