Provider Demographics
NPI:1467238287
Name:COATS, STEPHANIE M
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:COATS
Suffix:
Gender:F
Credentials:
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 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-258-3900
Mailing Address - Fax:
Practice Address - Street 1:1717 13TH STREET
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4601
Practice Address - Country:US
Practice Address - Phone:425-297-5560
Practice Address - Fax:425-297-5561
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA149621163WG0600X
WAAP61542452363L00000X
IAA176525363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0600XNursing Service ProvidersRegistered NurseGerontology