Provider Demographics
NPI:1912066747
Name:STOMAN, NAJIBULLAH SAYED (PA)
Entity type:Individual
Prefix:MR
First Name:NAJIBULLAH
Middle Name:SAYED
Last Name:STOMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SETTLER ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-2226
Mailing Address - Country:US
Mailing Address - Phone:253-588-5281
Mailing Address - Fax:253-512-6645
Practice Address - Street 1:35 SETTLER ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-2226
Practice Address - Country:US
Practice Address - Phone:253-588-5281
Practice Address - Fax:253-512-6645
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10001570363A00000X
WAVA00015779183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8350423Medicaid
WAPA8601Medicare UPIN
WA8350423Medicaid