Individual
STEVIE MAZYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 897-3320
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036109544
IL
207R00000X
Internal Medicine Physician
Primary
MD60616133
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902835697
—
WA
01
—
P01628726
RR PTAN WVH
WA
Enumeration date
07/03/2006
Last updated
10/25/2023
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