Provider Demographics
NPI:1932461258
Name:STANTON, STEPHANIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:STANTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 NW SLATE LN
Mailing Address - Street 2:UNIT 104
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9383
Mailing Address - Country:US
Mailing Address - Phone:706-260-5598
Mailing Address - Fax:
Practice Address - Street 1:2860 NW BUCKLIN HILL RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8513
Practice Address - Country:US
Practice Address - Phone:360-692-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60202655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60202655OtherPHARMACIST LICENSE
SC12847OtherPHARMACIST LICENSE
GA024780OtherPHARMACIST LICENSE