Healthcare Provider Details

I. General information

NPI: 1942686340
Provider Name (Legal Business Name): STEVEN ARMAND LEPINE LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 REID STREET, ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
TACOMA WA
98431-1000
US

IV. Provider business mailing address

9040 REID STREET, ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
TACOMA WA
98431-1000
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-0217
  • Fax:
Mailing address:
  • Phone: 253-968-0217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE1381578
License Number State
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP00046949
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: