Provider Demographics
NPI:1881643666
Name:MAURER, STACIE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:STACIE
Middle Name:ELIZABETH
Last Name:MAURER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:10400 NE 4TH ST STE 2250
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5174
Practice Address - Country:US
Practice Address - Phone:425-274-1003
Practice Address - Fax:206-267-4391
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2018-03-17
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Provider Licenses
StateLicense IDTaxonomies
WAMD00030354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAF00247Medicare UPIN