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General NPI Number Information
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NPI Number | 1255741419
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Entity Type | Individual
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Provider Name | STEPHANIE CARRIER HODGES MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 2211 QUEEN ANNE AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-2367
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Country | US
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Telephone | 206-861-8500
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Fax | 206-861-8501
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Provider Business Mailing Address
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Address Line | PO BOX 25608
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City | SALT LAKE CITY
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State | UT
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Zip | 84125-0608
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Country | US
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Telephone | 206-320-4476
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Fax | 206-568-7043
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60744389
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License Number State | WA
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