Individual
ROBERTA SUE STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 S CEDAR ST STE 103, TACOMA, WA 98405-2302
(253) 272-1812
(253) 682-1455
Mailing address
PO BOX 5098, TACOMA, WA 98415-0098
(253) 272-1812
(253) 682-1455
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
MD00034144
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5206592
AETNA
WA
05
—
8196362
—
WA
01
—
ST8122
REGENCE BLUE CROSS SHIELD
WA
Enumeration date
12/13/2006
Last updated
07/08/2007
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