Healthcare Provider Details

I. General information

NPI: 1043585664
Provider Name (Legal Business Name): PATRICIA ANN STONE LMP, CR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 12/26/2019
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17608 SE 269TH PL
COVINGTON WA
98042-4981
US

IV. Provider business mailing address

6310 111TH AVE E
PUYALLUP WA
98372-2876
US

V. Phone/Fax

Practice location:
  • Phone: 989-820-0180
  • Fax:
Mailing address:
  • Phone: 989-820-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60251395
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: