Provider Demographics
NPI:1154349249
Name:STAAB, BARBARA ANN (MS, ARNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:STAAB
Suffix:
Gender:F
Credentials:MS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27723 21ST PL S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6953
Mailing Address - Country:US
Mailing Address - Phone:253-529-3623
Mailing Address - Fax:
Practice Address - Street 1:30809 1ST AVE S STE G
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4074
Practice Address - Country:US
Practice Address - Phone:253-945-8130
Practice Address - Fax:253-839-1071
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0199177OtherLABOR AND INDUSTRIES
WA9612128Medicaid
WA9612128Medicaid
WA0199177OtherLABOR AND INDUSTRIES