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1841228426

NPI Code Detail

MEDICARE: STEPHEN M. DURCH MD

MEDICARE: STEPHEN M. DURCH 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	207Q00000X	Family Medicine Physician	MD00034271	WA
2	207QA0505X	Adult Medicine Physician	MD00034271	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	G8891461	OTHER	WA	MEDICARE - VALLEY MEDICAL GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841228426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN M. DURCH MD

Provider Business Mailing Address
First Line	:	3600 LIND AVE SW
Second Line	:	SUITE 100
City	:	RENTON
State	:	WA
Zip	:	98055-4934
Country	:	US
Telephone Number	:	425-690-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	24920 104TH AVE SE
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98030-6443
Country	:	US
Telephone Number	:	425-690-3420
Fax Number	:	425-690-9420

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	03/05/2020

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Directions to “ STEPHEN M. DURCH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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