Healthcare Provider Details

I. General information

NPI: 1659773109
Provider Name (Legal Business Name): ALLYSON MARIE STOKER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S L ST
TACOMA WA
98405-3720
US

IV. Provider business mailing address

311 S L ST
TACOMA WA
98405-3720
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1419
  • Fax:
Mailing address:
  • Phone: 253-403-1419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60445516
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: