Provider Demographics
NPI:1427028315
Name:STANFORD, DEBORAH JEANNE
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JEANNE
Last Name:STANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 143RD ST SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:206-383-8908
Mailing Address - Fax:
Practice Address - Street 1:15240 AURORA AVE N
Practice Address - Street 2:BARTELL DRUGS
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-365-5561
Practice Address - Fax:206-361-2980
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician