Provider Demographics
NPI:1437288768
Name:STEIN, DIANE C (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:C
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:4026 NE 55TH ST STE E200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4026 NE 55TH ST STE E200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2263
Practice Address - Country:US
Practice Address - Phone:206-525-7444
Practice Address - Fax:206-524-6674
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA121482084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
91-2152230OtherTAX ID NUMBER