Provider Demographics
NPI:1962065722
Name:CAMERON, STEPHANIE A (RN, CCM, CAPS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:CAMERON
Suffix:
Gender:F
Credentials:RN, CCM, CAPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9813 S 231ST ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-3144
Mailing Address - Country:US
Mailing Address - Phone:206-293-3078
Mailing Address - Fax:206-260-2877
Practice Address - Street 1:9813 S 231ST ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-3144
Practice Address - Country:US
Practice Address - Phone:206-293-3078
Practice Address - Fax:206-260-2877
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN603352240163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management