Provider Demographics
NPI:1619056231
Name:STAMPFLI, CAROLINE A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:A
Last Name:STAMPFLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 WESLEY ST STE 250
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1668
Mailing Address - Country:US
Mailing Address - Phone:360-435-2233
Mailing Address - Fax:360-435-3966
Practice Address - Street 1:875 WESLEY ST STE 250
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1668
Practice Address - Country:US
Practice Address - Phone:360-435-2233
Practice Address - Fax:360-435-3966
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003350363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8442519Medicaid
WA8442519Medicaid
WA8857975Medicare ID - Type Unspecified