Healthcare Provider Details

I. General information

NPI: 1720661580
Provider Name (Legal Business Name): MRS. BAILEY TROUT STEPHENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34612 6TH AVE STE 210
FEDERAL WAY WA
98003
US

IV. Provider business mailing address

34612 6TH AVE S STE 210
FEDERAL WAY WA
98003-8723
US

V. Phone/Fax

Practice location:
  • Phone: 253-927-1882
  • Fax: 253-927-1439
Mailing address:
  • Phone: 253-927-1882
  • Fax: 253-927-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN288465
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: