Provider Demographics
NPI:1083972996
Name:STEPPING STONE PEDIATRICS
Entity Type:Organization
Organization Name:STEPPING STONE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS-DWIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:513-257-5380
Mailing Address - Street 1:17256 NE 18TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3141
Mailing Address - Country:US
Mailing Address - Phone:513-257-5380
Mailing Address - Fax:
Practice Address - Street 1:8105 166TH AVE NE
Practice Address - Street 2:SUITE 202
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3999
Practice Address - Country:US
Practice Address - Phone:513-257-5380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60228488363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty