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General NPI Number Information
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NPI Number | 1952703258
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Entity Type | Individual
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Provider Name | STEPHANIE PEACE REZENDES PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 21911 76TH AVE W STE 211
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City | EDMONDS
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State | WA
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Zip | 98026-7918
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Country | US
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Telephone | 425-775-6651
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Fax | 425-670-6718
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Provider Business Mailing Address
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Address Line | 21911 76TH AVE W STE 211
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City | EDMONDS
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State | WA
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Zip | 98026-7918
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Country | US
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Telephone | 425-775-6651
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Fax | 425-670-6718
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA60613322
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License Number State | WA
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