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General NPI Number Information
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NPI Number | 1629259437
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Entity Type | Organization
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Legal Business Name | STEFFAN R. TOLLES, MD
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 1780 NW MYHRE RD STE 2360
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City | SILVERDALE
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State | WA
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Zip | 98383-8676
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Country | US
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Telephone | 360-662-1110
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Fax | 360-662-0826
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Provider Business Mailing Address
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Address Line | 1780 NW MYHRE RD STE 2360
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City | SILVERDALE
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State | WA
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Zip | 98383-8676
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Country | US
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Telephone | 360-662-1110
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Fax | 360-662-0826
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Authorized Official
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Title or Position | PHYSICIAN
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Name | STEFFAN R. TOLLES
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Credential | MD
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Telephone | 360-662-1110
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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 | MD00022023
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License Number State | WA
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