Individual
STEPHANIE A. GRANVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
751 NE BLAKELY DR, SUITE 4020, ISSAQUAH, WA 98029-6201
(425) 313-7124
(425) 313-7057
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60321925
WA
Other
Enumeration date
12/12/2005
Last updated
05/25/2021
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