Provider Demographics
NPI:1184171522
Name:FERRIS, STEPHANIE (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 18TH CT
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2255
Mailing Address - Country:US
Mailing Address - Phone:217-652-1952
Mailing Address - Fax:844-487-5553
Practice Address - Street 1:1096 18TH CT
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-2255
Practice Address - Country:US
Practice Address - Phone:217-652-1952
Practice Address - Fax:844-487-5553
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016031306111N00000X
PADC011267111NN1001X
WACH61090945111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor