Healthcare Provider Details

I. General information

NPI: 1114822376
Provider Name (Legal Business Name): STELLA RAE PEARCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 LINCOLN AVE STE C1
MUKILTEO WA
98275-1573
US

IV. Provider business mailing address

1723 18TH AVE APT 21
SEATTLE WA
98122-2784
US

V. Phone/Fax

Practice location:
  • Phone: 209-284-4151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: