Basic Information
Provider Information
NPI: 1699728881
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PACE
FirstName: STEVEN
MiddleName: ALBERT
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 BONNEY ST
Address2:  
City: STEILACOOM
State: WA
PostalCode: 983881502
CountryCode: US
TelephoneNumber: 2535882425
FaxNumber: 2535888218
Practice Location
Address1: 315 MLK JR. WAY
Address2: TACOMA EMERGENCY CARE PHYSICIANS
City: TACOMA
State: WA
PostalCode: 98405
CountryCode: US
TelephoneNumber: 2534038327
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 02/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X17617WAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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