Healthcare Provider Details

I. General information

NPI: 1295845402
Provider Name (Legal Business Name): YOLI STETSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 N 45TH ST
SEATTLE WA
98103-6701
US

IV. Provider business mailing address

905 SPRUCE ST STE 300
SEATTLE WA
98104-2474
US

V. Phone/Fax

Practice location:
  • Phone: 206-633-3350
  • Fax: 206-633-3113
Mailing address:
  • Phone: 206-461-6935
  • Fax: 206-461-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN00161032
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: