Healthcare Provider Details

I. General information

NPI: 1154145084
Provider Name (Legal Business Name): LAURA ALANA STEWART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 115TH ST STE 130
SEATTLE WA
98133-8416
US

IV. Provider business mailing address

9823 28TH AVE SE
EVERETT WA
98208-3513
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3344
  • Fax: 206-598-1250
Mailing address:
  • Phone: 206-919-7368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN60733994
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: