Basic Information
| Provider Information | |||||||||
| NPI: | 1225265556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEW | ||||||||
| FirstName: | STEFANIA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1840 E RAY RD | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852258720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553970197 | ||||||||
| FaxNumber: | 8002726512 | ||||||||
| Practice Location | |||||||||
| Address1: | 2707 COLBY AVE STE 718 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253395413 | ||||||||
| FaxNumber: | 4253394213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2009 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | N361143716 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163W00000X | N261140311 | WA | N | Nursing Service Providers | Registered Nurse | 363L00000X | RN558162 & NP18925 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.