Healthcare Provider Details

I. General information

NPI: 1730721168
Provider Name (Legal Business Name): STEPHANIE M MCATEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 NE 137TH AVE
VANCOUVER WA
98682-4933
US

IV. Provider business mailing address

601 NE 128TH ST
VANCOUVER WA
98685-3037
US

V. Phone/Fax

Practice location:
  • Phone: 866-525-0582
  • Fax:
Mailing address:
  • Phone: 360-607-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60963278
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60963278
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: