Provider Demographics
NPI:1245471028
Name:STENERSEN, MEGHANN MARLISE (DO; CAPTAIN)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:MARLISE
Last Name:STENERSEN
Suffix:
Gender:F
Credentials:DO; CAPTAIN
Other - Prefix:
Other - First Name:MEGHANN
Other - Middle Name:MARLISE
Other - Last Name:STROBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-626-9400
Mailing Address - Fax:
Practice Address - Street 1:2020 E 29TH AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3917
Practice Address - Country:US
Practice Address - Phone:509-626-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADO.00236207Q00000X
WAOP60492533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine