Healthcare Provider Details

I. General information

NPI: 1740208024
Provider Name (Legal Business Name): STEPHANIE ANN PADILLA SOLA MN, RNC, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BOREN AVE N
SEATTLE WA
98109-5501
US

IV. Provider business mailing address

510 BOREN AVE N
SEATTLE WA
98109-5501
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-5200
  • Fax: 206-320-5202
Mailing address:
  • Phone: 206-320-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30006388
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP30006388
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00137235
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: