Provider Demographics
NPI:1114680170
Name:STINGEL, TAYLOR (RN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:STINGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1493 YUKON HARBOR RD SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8507
Mailing Address - Country:US
Mailing Address - Phone:206-250-0482
Mailing Address - Fax:
Practice Address - Street 1:315 M.L.K. JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-8507
Practice Address - Country:US
Practice Address - Phone:206-250-0482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61070702163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic SurgeryGroup - Single Specialty