Healthcare Provider Details

I. General information

NPI: 1609838739
Provider Name (Legal Business Name): SHARI KAY STEFFENSRUD A.R.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4234
US

IV. Provider business mailing address

13212 83RD AVE E
PUYALLUP WA
98373-5466
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1619
  • Fax:
Mailing address:
  • Phone: 253-845-8270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP30004388
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: