Healthcare Provider Details

I. General information

NPI: 1497733620
Provider Name (Legal Business Name): SUSAN E STONE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 112TH AVE NE SUITE 150
BELLEVUE WA
98004-4500
US

IV. Provider business mailing address

1120 112TH AVE NE SUITE 150
BELLEVUE WA
98004-4500
US

V. Phone/Fax

Practice location:
  • Phone: 425-467-3978
  • Fax: 425-688-5281
Mailing address:
  • Phone: 426-467-3978
  • Fax: 425-688-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30006079
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: