Individual provider · Type 1 NPI

Shata Liam Stephenson Ii

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1619764461 Active

Practice location

240 S 40th St
Philadelphia, PA 19104-6030

Call (215) 898-8965 Map

Mailing address

3319 Hunter Blvd S
Seattle, WA 98144-7031

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1619764461

Shata Liam Stephenson Ii's National Provider Identifier is 1619764461, issued on Apr 24, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 26, 2025.