Healthcare Provider Details

I. General information

NPI: 1174276448
Provider Name (Legal Business Name): STEPHANIE LAPRECE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N HOWARD ST STE R
SPOKANE WA
99201-0508
US

IV. Provider business mailing address

300 LENORA ST, PMB 1081 PMB 1081
SEATTLE WA
98121
US

V. Phone/Fax

Practice location:
  • Phone: 206-305-5246
  • Fax:
Mailing address:
  • Phone: 206-305-5246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61461062
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: