MEDICARE: STEPHEN JOSEPH KIRCHNER MD

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	390200000X	Student in an Organized Health Care Education/Training Program	RTL24-0146	NC
2	390200000X	Student in an Organized Health Care Education/Training Program	ML61678705	WA

General Provider Information

NPI Number	:	1497515431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN JOSEPH KIRCHNER MD

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST # BB-1332
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-6524
Country	:	US
Telephone Number	:	206-685-6120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST # BB-1332
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-6524
Country	:	US
Telephone Number	:	828-771-3545
Fax Number	:

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

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	05/28/2025

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