Provider Demographics
NPI:1619001625
Name:EMERSON, STEPHANY LURAY (LMP)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:LURAY
Last Name:EMERSON
Suffix:
Gender:F
Credentials:LMP
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 213
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WA
Mailing Address - Zip Code:98570-0213
Mailing Address - Country:US
Mailing Address - Phone:360-269-8810
Mailing Address - Fax:
Practice Address - Street 1:129 GORE RD
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WA
Practice Address - Zip Code:98570
Practice Address - Country:US
Practice Address - Phone:360-269-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016166174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist