Healthcare Provider Details
I. General information
NPI: 1083972996
Provider Name (Legal Business Name): STEPPING STONE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2012
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15410 NE 24TH STREET SUITE A
BELLEVUE WA
98008
US
IV. Provider business mailing address
15410 NE 24TH STREET SUITE A
BELLEVUE WA
98008
US
V. Phone/Fax
- Phone: 425-941-9540
- Fax: 425-502-6229
- Phone: 425-941-9540
- Fax: 425-502-6229
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | AP60228488 |
| License Number State | WA |
VIII. Authorized Official
Name:
AMY
ADKINS-DWIVEDI
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 513-257-5380