Bethany Stull, LMP
Specialist in Tacoma, WA. Individual provider (NPI-1).
NPI number1508304585
StatusActive
Last updated in NPPESFeb 9, 2017
Details
- NPI
- 1508304585
- Entity type
- Individual (NPI-1)
- Name
- Bethany Stull
- Credential
- LMP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 9, 2017
- Last updated
- Feb 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | MA 60622268 | WA | Yes |
Practice location
1310 S Union AveSte A-202
Tacoma, WA 98405-1907
Phone 253-507-4631
Mailing address
3320 Sw 320th St Apt 25Federal Way, WA 98023-2260
Phone 253-797-6336
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