Provider Demographics
NPI:1043006927
Name:STEWART, EMILY OLIVIA
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:OLIVIA
Last Name:STEWART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 MARTIN LUTHER KING JR WAY APT C
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3979
Mailing Address - Country:US
Mailing Address - Phone:253-317-6397
Mailing Address - Fax:
Practice Address - Street 1:7808 PACIFIC AVE # 9
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7039
Practice Address - Country:US
Practice Address - Phone:253-317-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool