Provider Demographics
NPI:1699007690
Name:LINNELL, STEPHANIE E (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:LINNELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2220 CORNWALL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3719
Mailing Address - Country:US
Mailing Address - Phone:360-734-4404
Mailing Address - Fax:360-734-7409
Practice Address - Street 1:2913 5TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6748
Practice Address - Country:US
Practice Address - Phone:855-255-1750
Practice Address - Fax:855-255-0905
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA60136127363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant