Individual provider · Type 1 NPI
Stacey Jonelle Van Tassel, L.M.P.
Specialist · Black Diamond, WA
NPI number
1124214267
Active
Practice location
29034 216th Ave SE
Black Diamond, WA 98010-1297
Mailing address
26615 199th Pl SE
Covington, WA 98042-5087
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | MA00020492 (WA) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2 other providers at this address
Other specialist providers in Black Diamond
About NPI 1124214267
Stacey Jonelle Van Tassel, L.M.P.'s National Provider Identifier is 1124214267, issued on Sep 21, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Black Diamond, WA. The record was last updated on Sep 21, 2007.