Provider Demographics
NPI:1427066323
Name:STINNETT, ALISON M (PA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:STINNETT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:M
Other - Last Name:MACKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2606 NE LILLEHAMMER LN
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-9085
Mailing Address - Country:US
Mailing Address - Phone:253-576-9844
Mailing Address - Fax:
Practice Address - Street 1:21800 MARKET PL NW STE 103
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6667
Practice Address - Country:US
Practice Address - Phone:360-291-5700
Practice Address - Fax:360-637-0863
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004162363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1071703Medicaid
WAAB22992Medicare ID - Type Unspecified
P35621Medicare UPIN