Healthcare Provider Details

I. General information

NPI: 1588671796
Provider Name (Legal Business Name): STEFANIE NUNEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 TALBOT RD S STE 460
RENTON WA
98055-5773
US

IV. Provider business mailing address

4011 TALBOT RD S STE 460
RENTON WA
98055-5791
US

V. Phone/Fax

Practice location:
  • Phone: 425-251-5110
  • Fax: 425-793-7382
Mailing address:
  • Phone: 425-690-3484
  • Fax: 425-690-9084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD00037836
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD00037836
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD00037836
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: