Healthcare Provider Details

I. General information

NPI: 1699828038
Provider Name (Legal Business Name): CECILY EUNJUNG STONE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CECILY STONE ARNP

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date: 03/31/2026
Reactivation Date: 08/14/2026

III. Provider practice location address

3315 S 23RD ST STE 100
TACOMA WA
98405-1615
US

IV. Provider business mailing address

3315 S 23RD ST STE 100
TACOMA WA
98405-1615
US

V. Phone/Fax

Practice location:
  • Phone: 253-883-4140
  • Fax:
Mailing address:
  • Phone: 253-883-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number70149688
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number61194182
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberRC00052421
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: