Healthcare Provider Details

I. General information

NPI: 1629402169
Provider Name (Legal Business Name): STEPHANIE FENGLER THOMPSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2013
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 LAKE BELLEVUE DR STE 250
BELLEVUE WA
98005-2478
US

IV. Provider business mailing address

40 LAKE BELLEVUE DR STE 250
BELLEVUE WA
98005-2478
US

V. Phone/Fax

Practice location:
  • Phone: 206-327-8632
  • Fax:
Mailing address:
  • Phone: 206-327-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: