Provider Demographics
NPI:1215131750
Name:STOKKE, DEBORAH A (RN, ARNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:STOKKE
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-7916
Mailing Address - Country:US
Mailing Address - Phone:360-452-2767
Mailing Address - Fax:
Practice Address - Street 1:233 W 1ST ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-2654
Practice Address - Country:US
Practice Address - Phone:360-452-1134
Practice Address - Fax:360-452-5974
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001238363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health