Healthcare Provider Details

I. General information

NPI: 1083542864
Provider Name (Legal Business Name): STEFAN JOSEPH TORRES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SUNSET AVE N STE 100
EDMONDS WA
98020-3229
US

IV. Provider business mailing address

111 SUNSET AVE N STE 100
EDMONDS WA
98020-3229
US

V. Phone/Fax

Practice location:
  • Phone: 425-307-4682
  • Fax:
Mailing address:
  • Phone: 425-307-4682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberRN60302445
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: