Provider Demographics
NPI:1487035747
Name:SCHAUB, STEPHANIE KELLY (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KELLY
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 356043
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6043
Mailing Address - Country:US
Mailing Address - Phone:206-598-4100
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6043
Practice Address - Country:US
Practice Address - Phone:206-598-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD607716442085R0001X
MA263029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine