Provider Demographics
NPI:1386918837
Name:WOO, STEPHANIE D (DC, MBA)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:D
Last Name:WOO
Suffix:
Gender:F
Credentials:DC, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40291
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-4291
Mailing Address - Country:US
Mailing Address - Phone:425-243-7966
Mailing Address - Fax:
Practice Address - Street 1:1900 116TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3052
Practice Address - Country:US
Practice Address - Phone:425-243-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60236837111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8909907Medicare PIN
WAG8933040Medicare PIN