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General NPI Number Information
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NPI Number | 1255807020
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Entity Type | Individual
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Provider Name | KATHERINE B STANEK CNM
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Gender | Female
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-4430
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Country | US
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Telephone | 253-968-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 15910 42ND AVENUE CT E
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City | TACOMA
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State | WA
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Zip | 98446-3090
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Country | US
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Telephone | 703-895-9130
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Fax |
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0024176295
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | AP61076635
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License Number State | WA
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