Individual
AUDRA STALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4238
(253) 403-2938
(253) 403-2968
Mailing address
521 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4238
(253) 403-2938
(253) 403-2968
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61102565
WA
Other
Enumeration date
03/19/2018
Last updated
07/16/2021
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