Provider Demographics
NPI:1912346776
Name:STONEKING, AQUILA (MS)
Entity type:Individual
Prefix:
First Name:AQUILA
Middle Name:
Last Name:STONEKING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KEELA
Other - Middle Name:
Other - Last Name:STONEKING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:2580 S MONTESANO ST.
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98595
Mailing Address - Country:US
Mailing Address - Phone:360-268-9125
Mailing Address - Fax:
Practice Address - Street 1:2580 S MONTESANO ST.
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:WA
Practice Address - Zip Code:98595
Practice Address - Country:US
Practice Address - Phone:360-268-9125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA300213F174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist