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General NPI Number Information
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NPI Number | 1083972996
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Entity Type | Organization
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Legal Business Name | STEPPING STONE PEDIATRICS
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 8105 166TH AVE NE SUITE 202
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City | REDMOND
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State | WA
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Zip | 98052-3999
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Country | US
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Telephone | 513-257-5380
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Fax |
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Provider Business Mailing Address
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Address Line | 17256 NE 18TH PL
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City | BELLEVUE
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State | WA
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Zip | 98008-3141
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Country | US
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Telephone | 513-257-5380
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | AMY ADKINS-DWIVEDI
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Credential | NP
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Telephone | 513-257-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP60228488
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License Number State | WA
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