Healthcare Provider Details

I. General information

NPI: 1942387550
Provider Name (Legal Business Name): DIANA LYNN STONE-POORE MSN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33501 1ST WAY S
FEDERAL WAY WA
98003-6208
US

IV. Provider business mailing address

32913 49TH PL SW
FEDERAL WAY WA
98023-3326
US

V. Phone/Fax

Practice location:
  • Phone: 253-874-1638
  • Fax:
Mailing address:
  • Phone: 253-815-0104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP30003405
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberAP30003405
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: