Provider Demographics
NPI:1710030010
Name:STILES, DEBORAH D (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:STILES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 DUCHESS RD
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-7020
Mailing Address - Country:US
Mailing Address - Phone:425-337-4575
Mailing Address - Fax:425-740-1620
Practice Address - Street 1:1720 100TH PL SE STE 201
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3865
Practice Address - Country:US
Practice Address - Phone:425-337-4575
Practice Address - Fax:425-740-1620
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004089363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB28995Medicare ID - Type UnspecifiedGROUP#, I'M ONLY PROVIDER
GAB28996Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #
S80001Medicare UPIN