Provider Demographics
NPI:1871386581
Name:STANSBERRY, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:STANSBERRY
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 1:14205 SE 36TH ST
Mailing Address - Street 2:STE 100 PMB 704
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006
Mailing Address - Country:US
Mailing Address - Phone:425-445-3070
Mailing Address - Fax:
Practice Address - Street 1:4312 340TH PL SE
Practice Address - Street 2:
Practice Address - City:FALL CITY
Practice Address - State:WA
Practice Address - Zip Code:98024-5723
Practice Address - Country:US
Practice Address - Phone:425-445-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist