Healthcare Provider Details

I. General information

NPI: 1801350673
Provider Name (Legal Business Name): STEPHANIE MARIE BECHTOLD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 QUILEUTE HEIGHTS
LA PUSH WA
98350-0189
US

IV. Provider business mailing address

PO BOX 1974
FORKS WA
98331-1974
US

V. Phone/Fax

Practice location:
  • Phone: 360-374-4318
  • Fax: 360-374-5448
Mailing address:
  • Phone: 360-461-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60932051
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: