Provider Demographics
NPI:1740208024
Name:SOLA, STEPHANIE ANN PADILLA (MN, RNC, ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN PADILLA
Last Name:SOLA
Suffix:
Gender:F
Credentials:MN, RNC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BOREN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5501
Mailing Address - Country:US
Mailing Address - Phone:206-320-5200
Mailing Address - Fax:
Practice Address - Street 1:510 BOREN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5501
Practice Address - Country:US
Practice Address - Phone:206-320-5200
Practice Address - Fax:206-320-5202
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00137235163W00000X
WAAP30006388363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9640368Medicaid
WA0181056OtherLABOR & INDUSTRY
WA9640368Medicaid
WA8801656Medicare PIN