Individual
PAULA MAXINE STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8001
Mailing address
7741 ATCHINSON DR SE, LACEY, WA 98513-5365
(360) 888-8988
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61046147
WA
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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