MEDICARE: STEPHANIE FLORA R.D., C.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	1060761	WA

General Provider Information

NPI Number	:	1346646189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE FLORA R.D., C.D.

Provider Business Mailing Address
First Line	:	1700 WESTLAKE AVE N
Second Line	:	SUITE 700
City	:	SEATTLE
State	:	WA
Zip	:	98109-3012
Country	:	US
Telephone Number	:	360-220-1190
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 WESTLAKE AVE N
Second Line	:	SUITE 700
City	:	SEATTLE
State	:	WA
Zip	:	98109-3012
Country	:	US
Telephone Number	:	360-220-1190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	05/25/2016

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