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Individual

FAIRUZA MAGSUM STEVENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP STUDENT

Contact information

Practice address
700 E MILL PLAIN BLVD, VANCOUVER, WA 98663
(360) 254-4040
Mailing address
14204 NE SALMON CREEK AVE, VANCOUVER, WA 98686-9600
(360) 882-7008

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RN00139022
WA

Other

Enumeration date
11/16/2009
Last updated
03/05/2010
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