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Individual

MS. DIANA LYNN STONE-POORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, ARNP

Contact information

Practice address
33501 1ST WAY S, FEDERAL WAY, WA 98003-6208
(253) 874-1638
Mailing address
32913 49TH PL SW, FEDERAL WAY, WA 98023-3326
(253) 815-0104

Taxonomy

Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
AP30003405
WA
363LP2300X
Primary Care Nurse Practitioner
Primary
AP30003405
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3076ST
BLUE SHIELD #
WA
05
9613498
WA
01
P00394684
RAILROAD MC # VM
WA
01
US5792716
AETNA SPECIALIST PIN VM
WA
Enumeration date
11/01/2006
Last updated
05/18/2008
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