Healthcare Provider Details

I. General information

NPI: 1073939898
Provider Name (Legal Business Name): JUSTINE STREMICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 07/24/2024
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
JOINT BASE LEWIS MCCHORD WA
98431-1535
US

IV. Provider business mailing address

9040 JACKSON AVE
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-3885
  • Fax:
Mailing address:
  • Phone: 253-968-1390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number29033
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101263921
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: