Provider Demographics
NPI:1407006752
Name:STEPP, PAULA ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ANN
Last Name:STEPP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:SCHOMAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 66TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-7704
Mailing Address - Country:US
Mailing Address - Phone:618-363-6496
Mailing Address - Fax:
Practice Address - Street 1:24909 104TH AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2819
Practice Address - Country:US
Practice Address - Phone:253-850-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0279961223G0001X
390200000X
WADE607547571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2080021Medicaid