Healthcare Provider Details

I. General information

NPI: 1093787202
Provider Name (Legal Business Name): STEPHEN MICHAEL YOEST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER ATTN: MCHJ-R
TACOMA WA
98431-0001
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER ATTN: MCHJ-R
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-5604
  • Fax: 253-968-3140
Mailing address:
  • Phone: 253-968-5604
  • Fax: 253-968-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number289116-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: