Provider Demographics
NPI:1225265556
Name:LEW, STEFANIA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:STEFANIA
Middle Name:MARIE
Last Name:LEW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E RAY RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8720
Mailing Address - Country:US
Mailing Address - Phone:855-397-0197
Mailing Address - Fax:800-272-6512
Practice Address - Street 1:2707 COLBY AVE STE 718
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3564
Practice Address - Country:US
Practice Address - Phone:425-339-5413
Practice Address - Fax:425-339-4213
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAN361143716363L00000X
WAN261140311163W00000X
CARN558162 & NP18925363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse