Provider Demographics
NPI:1386662245
Name:FEIFS, STEPHANIE (FNP, ARNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:FEIFS
Suffix:
Gender:F
Credentials:FNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:3400 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3307
Practice Address - Country:US
Practice Address - Phone:206-320-3399
Practice Address - Fax:206-320-5506
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60205103367A00000X
WAAP60205114363LF0000X
WARN60205001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1386662245Medicaid
431560263OtherTRICARE WEST
MO132300087Medicare PIN
GA511I420030Medicare UPIN